Arizona Diagnostic Labs,LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ARIZONA DIAGNOSTIC LABS,LLC

Practice address

919 12TH PL Ste 14
Prescott, AZ 86305-1433

Phone

(928) 910-9608

Fax

(928) 227-2968

NPI assigned

Mar 17, 2015

Organization subpart

No

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

Authorized official

Name

Douglas Dolan

Title

Member

Phone

(928) 910-9608

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1265825103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 12TH PL STE 14",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051433",
            "telephone_number": "928-910-9608",
            "fax_number": "928-227-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 12TH PL STE 14",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051433",
            "telephone_number": "928-910-9608",
            "fax_number": "928-227-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA DIAGNOSTIC LABS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "DOLAN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "928-910-9608"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Clinical Medical Laboratory in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.