MEDICARE: DIAGNOSTIC HEALTH CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	293D00000X	Physiological Laboratory

General Provider Information

NPI Number	:	1457300451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAGNOSTIC HEALTH CORPORATION

Provider Business Mailing Address
First Line	:	2650 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1102
Country	:	US
Telephone Number	:	702-952-3640
Fax Number	:	702-952-3699

Provider Business Practice Location Address
First Line	:	2650 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1102
Country	:	US
Telephone Number	:	702-952-3640
Fax Number	:	702-952-3699

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	MRS. SHERI K MILLER
Credential	:
Telephone Number	:	205-685-5116

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	08/22/2020

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Directions to “DIAGNOSTIC HEALTH CORPORATION ” Practice Location

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