One Lab Diagnostics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ONE LAB DIAGNOSTICS, LLC

Practice address

3575 Lone Star Cir Ste 434
Fort Worth, TX 76177-8908

Phone

(817) 989-9479

Fax

(817) 989-9478

NPI assigned

Jun 14, 2016

Organization subpart

No

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

Authorized official

Name

Kyle Coates

Title

Manager

Phone

(817) 989-9479

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1720438484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 LONE STAR CIR STE 434",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761778908",
            "telephone_number": "817-989-9479",
            "fax_number": "817-989-9478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 LONE STAR CIR STE 434",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761778908",
            "telephone_number": "817-989-9479",
            "fax_number": "817-989-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE LAB DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A",
        "authorized_official_last_name": "COATES",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-989-9479"
    },
    "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": "45D2113785",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Fort Worth, TX
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• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.