Active NPI
Pure Diagnostic, LLC
- Clinical Medical Laboratory
- Atlanta, GA
National Provider Identifier
1659726487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- PURE DIAGNOSTIC, LLC
- Practice address
- 4025 Pleasantdale Rd Ste 525
Atlanta, GA 30340-4265 - Phone
- (423) 713-7481
- Fax
- (423) 713-7483
- NPI assigned
- Apr 29, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Abdel Halim
- Title
- Ceo/Cfo
- Phone
- (828) 606-6304
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
4025 Pleasantdale Rd Ste 525
Atlanta, GA 30340-4265
Mailing address
4025 Pleasantdale Rd Ste 525
Atlanta, GA 30340-4265
Phone (423) 713-7481
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44D2111056 | Other | GA | CLIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, GA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161017000594 | TN | Part B Supplier - Independent Clinical Laboratory | 8325336886 | Practice locations: Chattanooga, TN |
| O20200302000420 | GA | Part B Supplier - Independent Clinical Laboratory | 8325336886 | Practice locations: Atlanta, GA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2111056 | Pure Diagnostic LLC | Accreditation | Apr 26, 2027 |
National Provider Directory
National Provider DirectoryLocations
6120 Shallowford Rd
Ste 107
Chattanooga, TN 37421
Phone (423) 713-7481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461888000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773705600000",
"number": "1659726487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4025 PLEASANTDALE RD STE 525",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303404265",
"telephone_number": "423-713-7481",
"fax_number": "423-713-7483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 PLEASANTDALE RD STE 525",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303404265",
"telephone_number": "423-713-7481",
"fax_number": "423-713-7483"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PURE DIAGNOSTIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-04-29",
"last_updated": "2026-03-17",
"certification_date": "2026-03-17",
"status": "A",
"authorized_official_last_name": "HALIM",
"authorized_official_first_name": "ABDEL",
"authorized_official_title_or_position": "CEO/CFO",
"authorized_official_telephone_number": "828-606-6304",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "44D2111056",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; 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.