Versa Cardio LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

00050469 Issued in CA

Legal business name

VERSA CARDIO LLC

Practice address

255 E Rincon St Ste 210
Corona, CA 92879-1368

Phone

(855) 329-5794

Fax

(855) 399-5796

NPI assigned

Sep 6, 2013

Organization subpart

No

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

Authorized official

Name

Darin Slack

Title

Ceo

Phone

(855) 329-5794

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1366877508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E RINCON ST STE 210",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791368",
            "telephone_number": "855-329-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E RINCON ST STE 210",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791368",
            "telephone_number": "855-329-5794",
            "fax_number": "855-399-5796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERSA CARDIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-06",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "SLACK",
        "authorized_official_first_name": "DARIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-329-5794"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "CA",
            "license": "00050469",
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Ventrella
• Abigail Vera
• Britney Verduzco
• Daniela Verna
• Jair Veronica
• Jelicka Anna Calibo Verza
• Leticia Viana-Davalos
• Victoria Health Services for Home Care
• Ana Vidal
• Daniel-Champ Hilario Vidales

• Physiological Laboratory in Corona, CA
• Providers in Corona, CA by specialty
• Physiological Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.