Primary Diagnostics Laboratory PLLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PRIMARY DIAGNOSTICS LABORATORY PLLC

Practice address

115 S 17TH Ave
Hollywood, FL 33020-6801

Phone

(954) 505-7301

Fax

(954) 505-7302

NPI assigned

Jul 8, 2013

Last updated

Jul 8, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jean-Robert B DumasNPI 1528442092

Title

Owner

Phone

(973) 517-8740

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jean-Robert Dumas, MT

  • Clinical Laboratory Director (Non-physician)
  • Hollywood, FL
  • NPI 1528442092
  NPD Authorized official

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1942641923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S 17TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206801",
            "telephone_number": "954-505-7301",
            "fax_number": "954-505-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S 17TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206801",
            "telephone_number": "954-505-7301",
            "fax_number": "954-505-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY DIAGNOSTICS LABORATORY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "DUMAS",
        "authorized_official_first_name": "JEAN-ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-517-8740"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primary Care Physicians of Hollywood, PA
• Primary Care Physicians of Hollywood, PL
• Primary Care Physicians of Hollywood, PL
• Primary Care Physicins of Hollywood PA (PCP RX Direct)
• Primary Dental Partners PA
• Primary Medical Physicians, LLC
• Primary Medical Physicians, LLC
• Prime Pediatric Dental Group PA
• Prince Adam's Place
• Principletherapy LLC

• Clinical Medical Laboratory in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.