Advanced Diagnostic Services LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ADVANCED DIAGNOSTIC SERVICES LLC

Practice address

135 N Victory Blvd Ste a
Burbank, CA 91502-1837

Phone

(805) 341-2482

Fax

(805) 364-5925

NPI assigned

Oct 21, 2022

Last updated

Oct 21, 2022By 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

Phyllis Marilyn Wodin

Title

Owner

Phone

(805) 341-2482

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666310400000",
    "number": "1760109631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N VICTORY BLVD STE A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021837",
            "telephone_number": "805-341-2482",
            "fax_number": "805-364-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N VICTORY BLVD STE A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021837",
            "telephone_number": "805-341-2482",
            "fax_number": "805-364-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DIAGNOSTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A",
        "authorized_official_last_name": "WODIN",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "MARILYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-341-2482"
    },
    "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 Burbank, CA
• Providers in Burbank, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.