NPIMap

Organization Active NPI

Inform Diagnostics, Inc

  • Clinical Medical Laboratory
  • Ladera Ranch, CA
National Provider Identifier
1083490437
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
INFORM DIAGNOSTICS, INC
Practice address
7 Chianti
Ladera Ranch, CA 92694-1402
Phone
(949) 426-4798
NPI assigned
Sep 1, 2023
Last updated
Sep 1, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
INFORM DIAGNOSTICS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Authorized official

Name
Raymond Christopher Wicker
Title
Vice President
Phone
(678) 477-4402

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

7 Chianti
Ladera Ranch, CA 92694-1402

Mailing address

6655 N Macarthur Blvd
Irving, TX 75039-2443
Phone (346) 202-6091

National Provider Directory

National Provider Directory
Tax ID family
Caris Diagnostics6 organizations share this tax ID, including this one
Part of
Caris Diagnostics

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1083490437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392443",
            "telephone_number": "346-202-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CHIANTI",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926941402",
            "telephone_number": "949-426-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFORM DIAGNOSTICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INFORM DIAGNOSTICS, INC",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "WICKER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "678-477-4402"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladera Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.