NPIMap

Organization Active NPI

Kan-Di-Ki LLC

Doing business as Diagnostic Laboratories

  • Clinical Medical Laboratory
  • Las Vegas, NV
National Provider Identifier
1073859930
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
5562LIC-4 Issued in NV
Legal business name
KAN-DI-KI LLC
Doing business as
Diagnostic Laboratories
TridentCare
Practice address
7355 Prairie Falcon Rd
Las Vegas, NV 89128-0801
Phone
(702) 982-0533
Fax
(702) 982-0991
NPI assigned
Dec 21, 2012
Last updated
Mar 11, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
TRIDENTUSA HEALTH SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Brian C Cuomo
Title
Authorized Official/Cfo
Phone
(800) 786-8015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 5562LIC-4 NV Primary

Addresses

Primary practice location

7355 Prairie Falcon Rd
Las Vegas, NV 89128-0801

Mailing address

215 Schilling Cir Ste 114
Hunt Valley, MD 21031-1113
Phone (800) 786-8015

Other identifiers 2

IdentifierTypeStateIssuer
1073859930MedicaidNV
P01138750OtherNVRAILROAD MEDICARE

Other names 2

  • Diagnostic Laboratories Doing business as
  • TridentCare Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1356048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1073859930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SCHILLING CIR STE 114",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311113",
            "telephone_number": "800-786-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 PRAIRIE FALCON RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280801",
            "telephone_number": "702-982-0533",
            "fax_number": "702-982-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAN-DI-KI LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIDENTUSA HEALTH SERVICES, LLC",
        "enumeration_date": "2012-12-21",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "CUOMO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/CFO",
        "authorized_official_telephone_number": "800-786-8015"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NV",
            "license": "5562LIC-4",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073859930",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01138750",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diagnostic Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TridentCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.