Organization Active NPI

Clin-Path Diagnostics, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Tempe, AZ
National Provider Identifier
1154350932
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
CLIN-PATH DIAGNOSTICS, LLC
Practice address
2109 S. 48TH Street
Suite 102
Tempe, AZ 85282
Phone
(602) 424-2889
Fax
(602) 424-2569
NPI assigned
Jul 2, 2006
Last updated
Dec 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Authorized official

Name
Mr. Robert De la Torre
Title
C.O.O.
Phone
(602) 685-5211

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X AZ Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

2109 S. 48TH Street
Suite 102
Tempe, AZ 85282

Mailing address

PO Box 42210
Phoenix, AZ 85080
Phone (623) 889-7403

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1154350932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85080",
            "telephone_number": "623-889-7403",
            "fax_number": "623-889-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 S. 48TH STREET",
            "address_2": "SUITE 102",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "602-424-2889",
            "fax_number": "602-424-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIN-PATH DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "DE LA TORRE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "602-685-5211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.