Alive Diagnostics

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ALIVE DIAGNOSTICS

Practice address

2100 N Hwy 360 BLDG 4
Grand Prairie, TX 75050-1011

Phone

(972) 961-1119

NPI assigned

Apr 19, 2024

Organization subpart

No

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

Authorized official

Name

Roseline Boateng

Title

Owner

Phone

(347) 751-8595

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1699520999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N HWY 360 BLDG 4",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750501011",
            "telephone_number": "972-961-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N HWY 360 BLDG 4",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750501011",
            "telephone_number": "972-961-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIVE DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "BOATENG",
        "authorized_official_first_name": "ROSELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-751-8595"
    },
    "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 Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.