Active NPI
Precision Clinical Diagnostics LLC
- Mobile Radiology Clinic/Center
- Clarkston, GA
National Provider Identifier
1861136947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mobile Radiology Clinic/Center
- Legal business name
- PRECISION CLINICAL DIAGNOSTICS LLC
- Practice address
- 4600 E Ponce de Leon Ave Ste B
Clarkston, GA 30021-1839 - Phone
- (470) 418-4458
- NPI assigned
- Apr 25, 2022
- Last updated
- Apr 25, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dawit Mengesha
- Title
- President
- Phone
- (470) 418-4458
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mobile Radiology Clinic/Center | 261QR0208X | Primary |
Addresses
Primary practice location
4600 E Ponce de Leon Ave Ste B
Clarkston, GA 30021-1839
Mailing address
4600 E Ponce de Leon Ave Ste B
Clarkston, GA 30021-1839
Phone (470) 418-4458
National Provider Directory
National Provider DirectoryLocations
4600 E Ponce de Leon Ave
Ste B
Clarkston, GA 30021
Phone (470) 418-4458
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650844800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1650844800000",
"number": "1861136947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 E PONCE DE LEON AVE STE B",
"city": "CLARKSTON",
"state": "GA",
"postal_code": "300211839",
"telephone_number": "470-418-4458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 E PONCE DE LEON AVE STE B",
"city": "CLARKSTON",
"state": "GA",
"postal_code": "300211839",
"telephone_number": "470-418-4458"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRECISION CLINICAL DIAGNOSTICS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-04-25",
"last_updated": "2022-04-25",
"certification_date": "2022-04-25",
"status": "A",
"authorized_official_last_name": "MENGESHA",
"authorized_official_first_name": "DAWIT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "470-418-4458"
},
"taxonomies": [
{
"code": "261QR0208X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology, Mobile",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clarkston, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.