Organization Active NPI

Pradus Clinical DX LLC

  • Clinical Medical Laboratory
  • Longview, TX
National Provider Identifier
1780552893
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PRADUS CLINICAL DX LLC
Practice address
2840 Bill Owens Pkwy Ste D
Longview, TX 75605-2150
Phone
(213) 476-9779
NPI assigned
Oct 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Ansar Javed Dhillou
Title
Owner
Phone
(213) 476-9779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2840 Bill Owens Pkwy Ste D
Longview, TX 75605-2150

Mailing address

2840 Bill Owens Pkwy Ste D
Longview, TX 75605-2150

National Provider Directory

National Provider Directory

Locations

2840 Bill Owens Pkwy
Ste D
Longview, TX 75605
Phone (213) 476-9779

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1780552893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 BILL OWENS PKWY STE D",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 BILL OWENS PKWY STE D",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052150",
            "telephone_number": "213-476-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRADUS CLINICAL DX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "DHILLOU",
        "authorized_official_first_name": "ANSAR",
        "authorized_official_middle_name": "JAVED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-476-9779"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.