Organization Active NPI

Diagnostic Cytogenetics

  • Clinical Medical Laboratory
  • Seattle, WA
National Provider Identifier
1104899376
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
MTS-0439 Issued in WA
Legal business name
DIAGNOSTIC CYTOGENETICS
Practice address
2360 W Commodore Way Ste 201
Seattle, WA 98199-1285
Phone
(206) 328-2026
Fax
(206) 325-2975
NPI assigned
Feb 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Authorized official

Name
Kyndra M McDougal
Title
Chief Regulatory Officer
Phone
(888) 618-9107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X MTS-0439 WA Primary

Addresses

Primary practice location

2360 W Commodore Way Ste 201
Seattle, WA 98199-1285

Mailing address

2360 W Commodore Way Ste 201
Seattle, WA 98199-1285
Phone (206) 328-2026

Other identifiers 1

IdentifierTypeStateIssuer
7271406MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308001402 WA Part B Supplier - Independent Clinical Laboratory 2365330644 Practice locations: Seattle, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0721329Diagnostic Cytogenetics, LLC2360 W Commodore Way Ste 201, Seattle, WA 98199AccreditationApr 4, 2028

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2292 W Commodore Way
Ste 100
Seattle, WA 98199
Phone (206) 328-2026

1525 13th Ave
Seattle, WA 98122
Phone (206) 663-7510

2360 W Commodore Way
Ste 201
Seattle, WA 98199
Phone (206) 328-2026

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676505600000",
    "number": "1104899376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 W COMMODORE WAY STE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981991285",
            "telephone_number": "206-328-2026",
            "fax_number": "206-325-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 W COMMODORE WAY STE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981991285",
            "telephone_number": "206-328-2026",
            "fax_number": "206-325-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC CYTOGENETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "KYNDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF REGULATORY OFFICER",
        "authorized_official_telephone_number": "888-618-9107"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WA",
            "license": "MTS-0439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7271406",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.