Pharos Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

03D2120595 Issued in AZ

Legal business name

PHAROS DIAGNOSTICS LLC

Practice address

3814 E 5TH St
Tucson, AZ 85716-5145

Phone

(520) 355-4500

NPI assigned

Nov 8, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Michael Bergthold

Title

President and Ceo

Phone

(602) 885-3795

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1851833768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 VALLEY CENTRE DR",
            "address_2": "STE 705 PMB514",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303307",
            "telephone_number": "520-355-2500",
            "fax_number": "855-875-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 E 5TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857165145",
            "telephone_number": "520-355-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAROS DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "BERGTHOLD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "602-885-3795",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "03D2120595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kristi Hamblin Phelps, RDH

• Clinical Medical Laboratory in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Clinical Medical Laboratory in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.