Authentic Diagnostics Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

AUTHENTIC DIAGNOSTICS LABS LLC

Practice address

5520 LBJ Fwy Ste 190B
Dallas, TX 75240-6246

Phone

(469) 913-4453

Fax

(972) 408-0711

NPI assigned

Feb 7, 2022

Organization subpart

No

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

Authorized official

Name

Haroon Rasheed, MD

Title

Ceo

Phone

(972) 310-7121

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1184378457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 LBJ FWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406381",
            "telephone_number": "972-310-7121",
            "fax_number": "972-408-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 LBJ FWY STE 190B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406246",
            "telephone_number": "469-913-4453",
            "fax_number": "972-408-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC DIAGNOSTICS LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A",
        "authorized_official_last_name": "RASHEED",
        "authorized_official_first_name": "HAROON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-310-7121",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Dallas, TX
• Providers in Dallas, 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 Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.