Organization Active NPI

RGC Diagnostic

  • Clinical Medical Laboratory
  • Lake Wales, FL
National Provider Identifier
1033030580
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
RGC DIAGNOSTIC
Practice address
718 N Scenic Hwy
Lake Wales, FL 33853-3208
Phone
(863) 331-7450
NPI assigned
Jul 22, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Demika Gardner
Title
Owner
Phone
(863) 331-7450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

718 N Scenic Hwy
Lake Wales, FL 33853-3208

Mailing address

718 N Scenic Hwy
Lake Wales, FL 33853-3208
Phone (863) 331-7450

National Provider Directory

National Provider Directory

Locations

718 N Scenic Hwy
Lake Wales, FL 33853

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1784678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1033030580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 N SCENIC HWY",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533208",
            "telephone_number": "863-331-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 N SCENIC HWY",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533208",
            "telephone_number": "863-331-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RGC DIAGNOSTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-22",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "DEMIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-331-7450"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.