Organization Active NPI

Pure Diagnostic, LLC

  • Clinical Medical Laboratory
  • Atlanta, GA
National Provider Identifier
1659726487
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
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

Updated by the provider on Mar 17, 2026

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
44D2111056OtherGACLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2111056Pure Diagnostic LLC4025 Pleasantdale Road, BLDG 500, Suite 525, Atlanta, GA 30340AccreditationApr 26, 2027

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.