Brin Diagnostics Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

49D1100708 Issued in IL

Legal business name

BRIN DIAGNOSTICS INC.

Practice address

3216 W Kenwood
West Peoria, IL 61604

Phone

(309) 635-9963

NPI assigned

Feb 7, 2013

Last updated

Feb 7, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dan Harshbarger

Title

Manager

Phone

(309) 635-9963

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1720327976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 W KENWOOD",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "61604",
            "telephone_number": "309-635-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 W KENWOOD",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "61604",
            "telephone_number": "309-635-9963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIN DIAGNOSTICS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "HARSHBARGER",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "309-635-9963",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "49D1100708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "49D1100708",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in West Peoria, IL
• Providers in West Peoria, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.