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PROFESSIONAL PARK DIAGNOSTICS PLLC NPI 1235795352


NPI Information

NPI: 1235795352
Provider Name: PROFESSIONAL PARK DIAGNOSTICS PLLC
Classification: Clinical Medical Laboratory - 291U00000X
Entity Type: Organization

CLIA Number: 18D0992732

Address:
3346 PROFESSIONAL PARK
OWENSBORO, KY
ZIP 42303
Phone: (270) 685-1066
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PROFESSIONAL PARK DIAGNOSTICS PLLC is a clinical medical laboratory in Owensboro, KY. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. PROFESSIONAL PARK DIAGNOSTICS PLLC NPI is 1235795352. The provider is registered as an organization entity type.

The provider's business location address is:

3346 PROFESSIONAL PARK
OWENSBORO, KY
ZIP 42303-551
Phone: (270) 685-1066
Fax: (270) 713-0227

The provider's authorized official is Patrick Brian Gipe .
The authorized official title is Partner and has the following contact phone number (270) 685-1066.

The CLIA number assigned to this NPI record is 18D0992732 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/14/2019 and was last updated on 12/19/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0200XClinic/CenterRadiologyNo
2291U00000XClinical Medical LaboratoryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17100633920MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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