NPIMap

Organization Active NPI

Moran Diagnostic Services, LLC

  • Clinical Medical Laboratory
  • Lake Odessa, MI
National Provider Identifier
1447596747
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
D5394A Issued in MI
Legal business name
MORAN DIAGNOSTIC SERVICES, LLC
Practice address
777 Jordan Lake Ave
Lake Odessa, MI 48849-1217
Phone
(616) 902-5759
Fax
(616) 773-1292
NPI assigned
Dec 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Authorized official

Name
Dr. Christopher A Moran, DC
Title
President
Phone
(616) 902-5759

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X D5394A MI Primary

Addresses

Primary practice location

777 Jordan Lake Ave
Lake Odessa, MI 48849-1217

Mailing address

PO Box 634
Lake Odessa, MI 48849-0634
Phone (616) 902-5759

Other names 1

  • Physicians Mobile Imaging Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355443200000",
    "number": "1447596747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634",
            "city": "LAKE ODESSA",
            "state": "MI",
            "postal_code": "488490634",
            "telephone_number": "616-902-5759",
            "fax_number": "616-773-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 JORDAN LAKE AVE",
            "city": "LAKE ODESSA",
            "state": "MI",
            "postal_code": "488491217",
            "telephone_number": "616-902-5759",
            "fax_number": "616-773-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORAN DIAGNOSTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2012-12-14",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-902-5759",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "D5394A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Mobile Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Odessa, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; 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.