Tri-Valley Clinical Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

16840 Issued in AZ

Legal business name

TRI-VALLEY CLINICAL LABORATORY INC

Practice address

1281 E Cottonwood LN
Casa Grande, AZ 85222-2949

Phone

(520) 876-5770

Fax

(520) 876-5767

NPI assigned

Sep 1, 2005

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

Dr. Donald Wilton Hill, M.D.

Title

Medical Director

Phone

(520) 876-5770

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639163900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 E COTTONWOOD LN",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "852222949",
            "telephone_number": "520-876-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1281 E COTTONWOOD LN",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "852222949",
            "telephone_number": "520-876-5770",
            "fax_number": "520-876-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-VALLEY CLINICAL LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WILTON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "520-876-5770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "16840",
            "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.