Central Missouri Diagnostic Services, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CENTRAL MISSOURI DIAGNOSTIC SERVICES, LLC

Practice address

1705 Christy Dr
Suite 105
Jefferson City, MO 65101-5195

Phone

(573) 659-5460

Fax

(573) 659-5463

NPI assigned

Jul 18, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Katie J. Ortbals

Title

Laboratory Manager

Phone

(573) 659-5460

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1073868808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 CHRISTY DR",
            "address_2": "SUITE 105",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015195",
            "telephone_number": "573-659-5460",
            "fax_number": "573-659-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 CHRISTY DR",
            "address_2": "SUITE 105",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015195",
            "telephone_number": "573-659-5460",
            "fax_number": "573-659-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MISSOURI DIAGNOSTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "ORTBALS",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "LABORATORY MANAGER",
        "authorized_official_telephone_number": "573-659-5460",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Clinical Medical Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.