PCR-DX, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PCR-DX, LLC

Practice address

720 Main St SW Ste D
Gainesville, GA 30501-4400

Phone

(205) 861-1951

NPI assigned

Sep 1, 2020

Last updated

Oct 5, 2022By 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

Grady Phillips

Title

President

Phone

(205) 861-1951

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1497369045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70608",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354070608",
            "telephone_number": "205-861-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 MAIN ST SW STE D",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305014400",
            "telephone_number": "205-861-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCR-DX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "GRADY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-861-1951"
    },
    "taxonomies": [
        {
            "code": "207SM0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Medical Genetics, Molecular Genetic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.