Vista Clinical Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

VISTA CLINICAL DIAGNOSTICS LLC

Practice address

3303 U S Highway 29
Danville, VA 24540-1413

Phone

(352) 536-9279

Fax

(352) 536-9279

NPI assigned

Mar 26, 2014

Organization subpart

No

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

Authorized official

Name

Patricia E Owen

Title

Ex Director of Administration

Phone

(352) 536-9270

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Vista Clinical Diagnostics LLC

  • Clinical Medical Laboratory
  • Clermont, FL
  • NPI 1356326409

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402617600000",
    "number": "1780001859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 S HWY 27",
            "address_2": "SUITE 201",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118066",
            "telephone_number": "352-536-9270",
            "fax_number": "352-536-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 U S HIGHWAY 29",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245401413",
            "telephone_number": "352-536-9279",
            "fax_number": "352-536-9279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA CLINICAL DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-06-13",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EX DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "352-536-9270"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Danville, VA
• Providers in Danville, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.