Diagnostic Health Corporation

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

DIAGNOSTIC HEALTH CORPORATION

Doing business as

Diagnostic Health Waldorf

Practice address

12070 Old Line Ctr
Suite 305
Waldorf, MD 20602-2513

Phone

(301) 870-4190

Fax

(301) 870-4422

NPI assigned

May 10, 2006

Organization subpart

No

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

Authorized official

Name

Miss Donna L Burch

Title

Credentialing Specialist

Phone

(205) 981-4814

Specialties & licenses 1

Addresses

Other names 1

• Diagnostic Health Waldorf Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1720037104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 INVERNESS CENTER PKWY",
            "address_2": "SUITE 425",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352424814",
            "telephone_number": "205-981-4814",
            "fax_number": "205-994-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "SUITE 305",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022513",
            "telephone_number": "301-870-4190",
            "fax_number": "301-870-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "BURCH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "205-981-4814",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Health Waldorf",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physiological Laboratory in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Physiological Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; 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.