Active NPI
Diagnostic Cytogenetics
- Clinical Medical Laboratory
- Seattle, WA
National Provider Identifier
1104899376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- MTS-0439
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7271406 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040308001402 | WA | Part B Supplier - Independent Clinical Laboratory | 2365330644 | Practice locations: Seattle, WA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D0721329 | Diagnostic Cytogenetics, LLC | Accreditation | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryMember 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.