Diagnostic Laboratoy Services

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

MA27692 Issued in NJ

Legal business name

DIAGNOSTIC LABORATOY SERVICES

Practice address

279 3Rd Ave Ste 104
Long Branch, NJ 07740-6205

Phone

(732) 229-8711

Fax

(732) 229-0245

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Louis J Zinterhofer, MD

Title

President Pathologist

Phone

(732) 229-8711

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558575654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-229-8711",
            "fax_number": "732-229-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 3RD AVE STE 104",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406205",
            "telephone_number": "732-229-8711",
            "fax_number": "732-229-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC LABORATOY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZINTERHOFER",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT PATHOLOGIST",
        "authorized_official_telephone_number": "732-229-8711",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NJ",
            "license": "MA27692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3824705",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Jack Der Mesropian, D.O.
• Dermatology and Laser Center PA
• Shiv Desai
• Tuisha Desai, D.O.
• Diagnostic Genetics
• Lisa Dille, EDD. BCBA
• Filippina Dimitriadi, MD
• Patsy Dipasquale
• Pooja H Divan
• Richard L. Dixon, MSW,LCSW

• Clinical Medical Laboratory in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• 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.