Legacy Diagnostic Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LEGACY DIAGNOSTIC LAB LLC

Practice address

1651 N Collins Blvd # 135
Richardson, TX 75080-3658

Phone

(469) 872-0008

NPI assigned

Aug 21, 2020

Organization subpart

No

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

Authorized official

Name

Othman Albdour

Title

Owner

Phone

(678) 755-9468

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1114539046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 N COLLINS BLVD # 135",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803658",
            "telephone_number": "469-872-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 N COLLINS BLVD # 135",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803658",
            "telephone_number": "469-872-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DIAGNOSTIC LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-21",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "ALBDOUR",
        "authorized_official_first_name": "OTHMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-755-9468"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christie S Lee, D.D.S.
• Kathleen L Lee
• Napoleon Lee, M.D.
• Nicole Lee
• Legacy Anesthesia Consultants, PLLC
• Carley Legan
• Clarissa Gay Legardye
• Legasee Health LLC
• John Murray Lehman, PH.D.
• Rachel Lemme

• Clinical Medical Laboratory in Richardson, TX
• Providers in Richardson, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.