Dianon Systems Inc
Organization Active NPI Clinical Medical Laboratory · Woodbridge, CT
NPI 1497437446 · NPPES record last updated Aug 23, 2023
Key facts
- NPI
- 1497437446
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- DIANON SYSTEMS INC
- Practice address
- 12 Tallwood Rd
Woodbridge, CT 06525-1932 - Phone
- (203) 926-7463
- Fax
- (336) 436-1048
- NPI assigned
- Aug 1, 2023
- Organization subpart
- No
Authorized official
- Name
- Kimberly T Williams
- Title
- Vice President
- Phone
- (336) 222-7566
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 3
Practitioners 3
-
Rosina Estela Decampo, M.D.
-
Suha H Mishalani, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 07D2283699 | Dianon Systems Inc | Compliance | Oct 9, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040206000682 | CT | Part B Supplier - Independent Clinical Laboratory | 8123931250 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Shelton, CT; Woodbridge, CT |
National Provider Directory
- Tax ID family
- Dianon Systems Inc
Locations
216 Congers Rd
New City, NY 10956
Phone (845) 634-1604
840 Research Pkwy
Fl 4
Oklahoma City, OK 73104
Phone (405) 290-4000
840 Research Pkwy
#4
Oklahoma City, OK 73104
Phone (405) 290-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
12 Tallwood Rd
Woodbridge, CT 06525-1932
Mailing address
PO Box 2270
Burlington, NC 27216-2270
Phone (800) 222-7566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07D2283699 | Other | CT | CLIA |
Other providers in Woodbridge, CT
- Michael M Demetriades
- Nicole Marie Derobertis
- Nicholas Despoelberch
- Daron Dey
- Ava L Diamond
- Jennifer Dinallo
- Dove Health Medical Supplies LLC
- Michael Dow
- Andrew Dows
- Dr. Benjamin Szczypek, LLC
All providers in Woodbridge, CT · Clinical Medical Laboratory in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.