QR Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

QR DIAGNOSTICS LLC

Practice address

12734 Kenwood LN
Unit 68
Fort Myers, FL 33907-5666

Phone

(561) 859-3413

Fax

(561) 423-0104

NPI assigned

Mar 16, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Jordan Whitehead

Title

Ceo

Phone

(561) 859-3413

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

Locations

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1366803447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12734 KENWOOD LN",
            "address_2": "UNIT 68",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075666",
            "telephone_number": "561-859-3413",
            "fax_number": "561-423-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12734 KENWOOD LN",
            "address_2": "UNIT 68",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075666",
            "telephone_number": "561-859-3413",
            "fax_number": "561-423-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QR DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-859-3413",
        "authorized_official_name_prefix": "Mr."
    },
    "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 Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.