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NPI Code Detail

MEDICARE: BLACK BOX DIAGNOSTICS

MEDICARE: BLACK BOX DIAGNOSTICS
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician

General Provider Information

NPI Number : 1568329423
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLACK BOX DIAGNOSTICS
Provider Business Mailing Address
First Line : 12 RONNIE WAYNE CIRCLE
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35213-4420
Country : US
Telephone Number : 205-939-7056
Fax Number :
Provider Business Practice Location Address
First Line : 810 ST. VINCENT'S DRIVE
Second Line : DEPARTMENT OF PATHOLOGY
City : BIRMINGHAM
State : AL
Zip : 35205-1601
Country : US
Telephone Number : 205-939-7056
Fax Number :
Authorized Official
Title or Position : MANAGING PARTNER
Name : WARREN JEFFERSON CLINGAN
Credential : M.D.
Telephone Number : 205-939-7056
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “BLACK BOX DIAGNOSTICS ” Practice Location

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