Clinical Disgnostics Labs

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

044-148 Issued in GA

Legal business name

CLINICAL DISGNOSTICS LABS

Practice address

2910 N. Druid Hills Rd
Suite D
Atlanta, GA 30329

Phone

(404) 728-9004

Fax

(404) 728-9011

NPI assigned

May 3, 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

Ms. Sheela Puthumana, M.T. (ASCP)

Title

Lab Manager Lab Owner

Phone

(404) 728-9007

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528280849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 N. DRUID HILLS RD",
            "address_2": "SUITE D",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30329",
            "telephone_number": "404-728-9004",
            "fax_number": "404-728-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 N. DRUID HILLS RD",
            "address_2": "SUITE D",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30329",
            "telephone_number": "404-728-9004",
            "fax_number": "404-728-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL DISGNOSTICS LABS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PUTHUMANA",
        "authorized_official_first_name": "SHEELA",
        "authorized_official_title_or_position": "LAB MANAGER       LAB OWNER",
        "authorized_official_telephone_number": "404-728-9007",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.T. (ASCP)"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "044-148",
            "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 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.