Organization Active NPI

Puretest Diagnostics

  • Clinical Medical Laboratory
  • Milton, FL
National Provider Identifier
1508720590
Registry record updated Dec 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PURETEST DIAGNOSTICS
Practice address
4966 Pineview Ridge Rd
Milton, FL 32571-8030
Phone
(850) 426-8048
NPI assigned
Dec 13, 2025
Last updated
Dec 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2025

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

Authorized official

Name
Shaquille Johnson
Title
Manager
Phone
(850) 378-6225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

4966 Pineview Ridge Rd
Milton, FL 32571-8030

Mailing address

4966 Pineview Ridge Rd
Milton, FL 32571-8030

National Provider Directory

National Provider Directory

Locations

4966 Pineview Ridge Rd
Milton, FL 32571
Phone (850) 426-8048

NPI Registry JSON

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

{
    "created_epoch": "1765584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765584000000",
    "number": "1508720590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4966 PINEVIEW RIDGE RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325718030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4966 PINEVIEW RIDGE RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325718030",
            "telephone_number": "850-426-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURETEST DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-13",
        "last_updated": "2025-12-13",
        "certification_date": "2025-12-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHAQUILLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "850-378-6225"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2025; 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.