Stat Diagnostics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

STAT DIAGNOSTICS, LLC

Practice address

4317 Ridgewood Center Dr
Woodbridge, VA 22192-5308

Phone

(703) 586-9740

Fax

(703) 586-9740

NPI assigned

Mar 16, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Zakevia Denise Green, PHD

Title

Ceo

Phone

(703) 762-6855

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1245931286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 RIDGEWOOD CENTER DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925308",
            "telephone_number": "703-586-9740",
            "fax_number": "703-586-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 RIDGEWOOD CENTER DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925308",
            "telephone_number": "703-586-9740",
            "fax_number": "703-586-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAT DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "ZAKEVIA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-762-6855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "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 Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.