Lightmicron Diagnostics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

0401004979 Issued in VA

Legal business name

LIGHTMICRON DIAGNOSTICS, LLC

Practice address

10347 Democracy Lane
B
Fairfax, VA 22030

Phone

(703) 281-5970

NPI assigned

Aug 25, 2006

Last updated

Nov 12, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Doug Arendt, DDS,MS

Title

Director

Phone

(703) 281-5970

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1073621504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1447",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220381447",
            "telephone_number": "703-281-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10347 DEMOCRACY LANE",
            "address_2": "B",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-281-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTMICRON DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "ARENDT",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-281-5970",
        "authorized_official_credential": "DDS,MS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "VA",
            "license": "0401004979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.