Granite Diagnostic Laboratories, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

800009395 Issued in FL

Legal business name

GRANITE DIAGNOSTIC LABORATORIES, INC.

Practice address

2150 Alt 19
Suite a
Palm Harbor, FL 34683-5363

Phone

(727) 771-6343

Fax

(727) 771-2942

NPI assigned

Aug 4, 2006

Last updated

Jan 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. Brain D Granite

Title

Owner

Phone

(727) 771-6343

Specialties & licenses 1

Addresses

Other names 1

• Granite Diagnostic Laboratory Other name

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1770591489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 ALT 19",
            "address_2": "SUITE A",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346835363",
            "telephone_number": "727-771-6343",
            "fax_number": "727-771-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 ALT 19",
            "address_2": "SUITE A",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346835363",
            "telephone_number": "727-771-6343",
            "fax_number": "727-771-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE DIAGNOSTIC LABORATORIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "GRANITE",
        "authorized_official_first_name": "BRAIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-771-6343",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800009395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granite Diagnostic Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Graceworks Wellness, LLC
• Kourtney Gracie
• Izmini M Grady, LCSW
• Terri A Graffeo, DPT
• Dawn Graham
• Alan Graves, M.D.
• James William Graybill III, MD
• Lauren Eve Greco, CNA, HHA, MED TECH
• Dustin Green, PT, DPT
• Lee Allen Greenberg, CPO/LPO

• Clinical Medical Laboratory in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Clinical Medical Laboratory in Florida

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