Personal Diagnostix Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

49D2080603 Issued in VA

Legal business name

PERSONAL DIAGNOSTIX INC.

Practice address

6734 Curran St
McLean, VA 22101-3803

Phone

(703) 349-1979

NPI assigned

Aug 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Zhifeng Long

Title

President

Phone

(301) 305-2689

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1841676400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6734 CURRAN STREET",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221013803",
            "telephone_number": "703-349-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6734 CURRAN ST",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221013803",
            "telephone_number": "703-349-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL DIAGNOSTIX INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ZHIFENG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-305-2689",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "VA",
            "license": "49D2080603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CLIA ID NUMBER",
            "identifier": "49D2080603",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Fitzgerald Pereddo, LPTA
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• Jennifer Lewis Pfab, PT
• Susan McKool Pfeffer, LCSW

• Clinical Medical Laboratory in McLean, VA
• Providers in McLean, 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 Aug 6, 2015; 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.