Labtech Diagnostic, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LABTECH DIAGNOSTIC, LLC

Practice address

1502 E Greenville St
Anderson, SC 29621-2005

Phone

(864) 760-0039

Fax

(864) 760-0051

NPI assigned

Jan 17, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Alyosef Labashabazid

Title

President/Owner

Phone

(864) 760-0039

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1386915700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 E GREENVILLE ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 E GREENVILLE ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212005",
            "telephone_number": "864-760-0039",
            "fax_number": "864-760-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABTECH DIAGNOSTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-17",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "LABASHABAZID",
        "authorized_official_first_name": "ALYOSEF",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "864-760-0039",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leila Kutob, MD
• Kimberly Gail Kyker, MD
• David Louis Kyle Jr., M.D.
• Emily Kyle, OTR/L
• Kim-Leigh Allison Laboard, RN
• Zoanne L. Lacabe, CRNA
• Walter Burke Lackey, MD
• Mark Lacy, MD
• Chloe Laguardia
• Lakeside Family Dentistry

• Clinical Medical Laboratory in Anderson, SC
• Providers in Anderson, SC by specialty
• Clinical Medical Laboratory in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.