NPIMap

Organization Active NPI

Southern Diagnostic Services, Inc.

  • Physiological Laboratory
  • Albany, GA
National Provider Identifier
1114102019
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
SOUTHERN DIAGNOSTIC SERVICES, INC.
Practice address
425 W 3Rd Ave
Suite 510
Albany, GA 31701-1941
Phone
(229) 312-7519
Fax
(229) 312-7505
NPI assigned
Jan 9, 2008
Last updated
Jan 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Authorized official

Name
Mr. Paul F. Hendley Jr.NPI 1750547600
Title
President / Ceo
Phone
(229) 886-5972

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

425 W 3Rd Ave
Suite 510
Albany, GA 31701-1941

Mailing address

425 W 3Rd Ave
Suite 510
Albany, GA 31701-1941
Phone (229) 312-7519

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
11D1101212Employee Health Services425 3Rd Ave Ste 105, Albany, GA 31701Provider-performed microscopyJun 22, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1114102019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W 3RD AVE",
            "address_2": "SUITE 510",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011941",
            "telephone_number": "229-312-7519",
            "fax_number": "229-312-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 3RD AVE",
            "address_2": "SUITE 510",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011941",
            "telephone_number": "229-312-7519",
            "fax_number": "229-312-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DIAGNOSTIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "HENDLEY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "229-886-5972",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.