DPG Reference Lab, PLLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

0453898 Issued in TN

Legal business name

DPG REFERENCE LAB, PLLC

Practice address

220 S Claybrook St
Suite 401
Memphis, TN 38104-3527

Phone

(901) 725-7551

Fax

(901) 726-6085

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dorothy L Black

Title

Managed Care Coordinator

Phone

(901) 725-7551

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548386642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE",
            "address_2": "SUITE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046638",
            "telephone_number": "901-725-7551",
            "fax_number": "901-726-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S CLAYBROOK ST",
            "address_2": "SUITE 401",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043527",
            "telephone_number": "901-725-7551",
            "fax_number": "901-726-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DPG REFERENCE LAB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGED CARE COORDINATOR",
        "authorized_official_telephone_number": "901-725-7551"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "0453898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Medical Laboratory in Tennessee

• 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.