Legacy Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LEGACY LABS LLC

Doing business as

Veridia Diagnostics

Practice address

106 E Old Settlers Blvd Ste D106
Round Rock, TX 78664

Phone

(512) 770-1700

Fax

(510) 373-2382

NPI assigned

May 19, 2009

Last updated

Aug 31, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debra Jefferson

Title

Director Revenue Cycle

Phone

(512) 770-1698

Specialties & licenses 1

Addresses

Other names 1

• Veridia Diagnostics Doing business as

Locations

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535673600000",
    "number": "1184859191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E OLD SETTLERS BLVD STE D106",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786642541",
            "telephone_number": "512-770-1700",
            "fax_number": "510-373-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E OLD SETTLERS BLVD STE D106",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78664",
            "telephone_number": "512-770-1700",
            "fax_number": "510-373-2382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Harbor Bay Pkwy#200",
            "address_purpose": "LOCATION",
            "city": "Alameda",
            "state": "CA",
            "postal_code": "94502",
            "country_code": "US",
            "telephone_number": "800-400-4344 x4763",
            "fax_number": "510-995-3935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEGACY LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2018-08-31",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "512-770-1698"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Veridia Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Veridia Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia C Lee, M.D.
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• Winifred Lee, LPC
• Yunkyung Lee, PHARM.D.
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• Kristyn Briana Leija
• Jennifer Elaine Leininger Nicholson, M.D.
• Rebecca Floyd Leissner, PT, DPT
• Lemons 2 Lemonade Counseling PLLC

• Clinical Medical Laboratory in Round Rock, TX
• Providers in Round Rock, 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 Aug 31, 2018; 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.