Organization Active NPI

Sunridge Diagnostics LLC

  • Clinical Medical Laboratory
  • Dallas, TX
National Provider Identifier
1689494387
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SUNRIDGE DIAGNOSTICS LLC
Practice address
11056 Shady TRL Ste 109
Dallas, TX 75229-5624
Phone
(682) 203-8832
NPI assigned
Oct 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Damon Sacks
Title
President
Phone
(682) 203-8832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

11056 Shady TRL Ste 109
Dallas, TX 75229-5624

Mailing address

6814 Prosper St
Dallas, TX 75209-4610
Phone (682) 203-8832

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
45D2307469Sunridge Diagnostics, LLC11056 Shady Trail, Suite 109, Dallas, TX 75229RegistrationJul 8, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1689494387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6814 PROSPER ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752094610",
            "telephone_number": "682-203-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11056 SHADY TRL STE 109",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752295624",
            "telephone_number": "682-203-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRIDGE DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "SACKS",
        "authorized_official_first_name": "DAMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "682-203-8832"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.