Reveal Diagnostic Services, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

REVEAL DIAGNOSTIC SERVICES, INC

Practice address

3915 Cascade Rd SW Ste 355
Atlanta, GA 30331-8520

Phone

(404) 549-9680

NPI assigned

Nov 6, 2019

Organization subpart

No

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

Authorized official

Name

Carolyn Weller

Title

Owner

Phone

(404) 549-9680

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1285278846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW STE 355",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW STE 355",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318520",
            "telephone_number": "404-549-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVEAL DIAGNOSTIC SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-06",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "WELLER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-549-9680"
    },
    "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 Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.