Decatur Diagnostic Laboratory, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

DECATUR DIAGNOSTIC LABORATORY, INC.

Practice address

2828 Highway 31 S
Decatur, AL 35603-1538

Phone

(256) 355-9045

Fax

(256) 355-9061

NPI assigned

Apr 13, 2006

Reactivated

Jul 28, 2008

Last updated

Jul 29, 2008By 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

Mrs. Kelly England, M.T.

Title

Lab Manager

Phone

(256) 355-9045

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1598729089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 HIGHWAY 31 S",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031538",
            "telephone_number": "256-355-9045",
            "fax_number": "256-355-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 HIGHWAY 31 S",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031538",
            "telephone_number": "256-355-9045",
            "fax_number": "256-355-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR DIAGNOSTIC LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-07-29",
        "deactivation_date": "2008-06-03",
        "reactivation_date": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "ENGLAND",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "LAB MANAGER",
        "authorized_official_telephone_number": "256-355-9045",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Decatur, AL
• Providers in Decatur, AL by specialty
• Clinical Medical Laboratory in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.