NPIMap

Organization Active NPI

Southern Diagnostic Laboratories, LLC

  • Clinical Medical Laboratory
  • Montgomery, AL
National Provider Identifier
1255647046
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SOUTHERN DIAGNOSTIC LABORATORIES, LLC
Practice address
463 Saint Lukes Dr
Montgomery, AL 36117-7107
Phone
(334) 279-5412
NPI assigned
Aug 31, 2010
Last updated
Aug 31, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Authorized official

Name
Mr. Ross W Jones
Title
Billing Manager
Phone
(334) 358-5966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

463 Saint Lukes Dr
Montgomery, AL 36117-7107

Mailing address

2732 7TH Ave S
Birmingham, AL 35233-3406

National Provider Directory

National Provider Directory
Tax ID family
Southern Diagnostic Laboratories LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

2732 7th Ave S
Birmingham, AL 35233
Phone (205) 313-1240

463 Saint Lukes Dr
Montgomery, AL 36117
Phone (334) 279-5412

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1255647046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2732 7TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352333406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 SAINT LUKES DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177107",
            "telephone_number": "334-279-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DIAGNOSTIC LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "334-358-5966",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.