Celligent Diagnostics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CELLIGENT DIAGNOSTICS, LLC

Practice address

6135 Lakeview Rd Ste 350
Charlotte, NC 28269-2627

Phone

(704) 549-8444

NPI assigned

Jan 24, 2019

Organization subpart

No

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

Authorized official

Name

Alfred Wray Campbell, MD

Title

President

Phone

(864) 560-6229

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Celligent Diagnostics LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Celligent Diagnostics, LLC

  • Clinical Medical Laboratory
  • Spartanburg, SC
  • NPI 1093950859
  NPD tax ID

Locations

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1316401375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96786",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282966786",
            "telephone_number": "704-973-5500",
            "fax_number": "704-973-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 LAKEVIEW RD STE 350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282692627",
            "telephone_number": "704-549-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELLIGENT DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-24",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "WRAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-560-6229",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7001318",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Charlotte, NC
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.