Tristar Diagnostics Laboratories

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TRISTAR DIAGNOSTICS LABORATORIES

Practice address

1339 Ridgeview Dr
Cedar Hill, TX 75104-6234

Phone

(972) 885-8172

Fax

(214) 602-6172

NPI assigned

Sep 21, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Darrylle M Kevianne II, LVN

Title

Owner

Phone

(972) 885-8172

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506297600000",
    "number": "1326557398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 RIDGEVIEW DR",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 RIDGEVIEW DR",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046234",
            "telephone_number": "972-885-8172",
            "fax_number": "214-602-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAR DIAGNOSTICS LABORATORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-25",
        "status": "A",
        "authorized_official_last_name": "KEVIANNE",
        "authorized_official_first_name": "DARRYLLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-885-8172",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "LVN"
    },
    "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 Cedar Hill, TX
• Providers in Cedar Hill, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; 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.