Renaissance DX LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

RENAISSANCE DX LLC

Practice address

9830 S 51St St Ste A124
Phoenix, AZ 85044-5672

Phone

(480) 608-1730

NPI assigned

May 11, 2021

Organization subpart

No

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

Authorized official

Name

David Ronda

Title

General Manager

Phone

(480) 221-5681

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1124602552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9830 S 51ST ST STE A124",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850445672",
            "telephone_number": "480-608-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9830 S 51ST ST STE A124",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850445672",
            "telephone_number": "480-608-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE DX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "RONDA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "480-221-5681"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sydney Michelle Renard

• Clinical Medical Laboratory in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Medical Laboratory in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.