Enova Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ENOVA DIAGNOSTICS LLC

Practice address

2860 Exchange Blvd Ste 180
Southlake, TX 76092-9151

Phone

(817) 410-8886

Fax

(817) 410-8887

NPI assigned

May 19, 2021

Last updated

Aug 11, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ahmad M Hadian

Title

Authorized Official

Phone

(817) 410-8886

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1417521782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 EXCHANGE BLVD STE 180",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929151",
            "telephone_number": "817-410-8886",
            "fax_number": "817-410-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 EXCHANGE BLVD STE 180",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929151",
            "telephone_number": "817-410-8886",
            "fax_number": "817-410-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENOVA DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "HADIAN",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "817-410-8886",
        "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 Southlake, TX
• Providers in Southlake, 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 Aug 11, 2021; 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.