Lahontan Valley Diagnostic

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

162277 Issued in NV

Legal business name

LAHONTAN VALLEY DIAGNOSTIC

Practice address

993 W Williams Ave
Fallon, NV 89406-2631

Phone

(775) 423-6715

Fax

(775) 423-6716

NPI assigned

Feb 22, 2007

Last updated

Aug 22, 2020By 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. Garry Craig Jackson

Title

President Owner

Phone

(775) 423-6715

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Nelson Held, MD

  • Pulmonary Disease Physician
  • Sparks, NV
  • NPI 1427040187
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447385273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "993 W WILLIAMS AVE",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894062631",
            "telephone_number": "775-423-6715",
            "fax_number": "775-423-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "993 W WILLIAMS AVE",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894062631",
            "telephone_number": "775-423-6715",
            "fax_number": "775-423-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAHONTAN VALLEY DIAGNOSTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GARRY",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "775-423-6715",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NV",
            "license": "162277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skyler Koelsch
• Davis Koenig
• Pamela Krause
• Tomas Kutansky, D.D.S.
• Michael Lagrone
• Mary Anne Lakin
• Joy Lawson
• Frank King Lee, CRNA
• Christopher Thomas Lemieux
• Chao Ran Li, PHARM.D.

• Clinical Medical Laboratory in Fallon, NV
• Providers in Fallon, NV by specialty
• Clinical Medical Laboratory in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.