Discover Diagnostic Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

DISCOVER DIAGNOSTIC LABORATORY, LLC

Practice address

702 S Illinois Ave
Suite B-104
Oak Ridge, TN 37830-7908

Phone

(855) 314-3337

Fax

(888) 965-6670

NPI assigned

Aug 20, 2014

Organization subpart

No

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

Authorized official

Name

John Coffman

Title

Ceo

Phone

(865) 257-0569

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Discover Diagnostic Laboratory, LLC

  • Clinical Medical Laboratory
  • Houston, TX
  • NPI 1134973084

  5395060388

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Discover Diagnostic Laboratory LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Discover Diagnostic Laboratory, LLC

  • Clinical Medical Laboratory
  • Houston, TX
  • NPI 1134973084
  NPD tax ID

Locations

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1154720662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 S ILLINOIS AVE",
            "address_2": "SUITE B-104",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378307908",
            "telephone_number": "855-314-3337",
            "fax_number": "888-965-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S ILLINOIS AVE",
            "address_2": "SUITE B-104",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378307908",
            "telephone_number": "855-314-3337",
            "fax_number": "888-965-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISCOVER DIAGNOSTIC LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-20",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "COFFMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "865-257-0569"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasey Lee Dillingham, LMSW
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• Justin Tyler Dinsmore, DDS
• Virginia Dionne
• Andrea H Ditmore, SLP
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• Lilly DO
• Elizabeth Julissa Dockery, D.O.

• Clinical Medical Laboratory in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Clinical Medical Laboratory in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.

Verify at the official NPI Registry.