Healthcare Provider Details

I. General information

NPI: 1528904661
Provider Name (Legal Business Name): GLOBAL DIAGNOSTIC LAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W CLARENDON AVE OFC NO3253
PHOENIX AZ
85013-3420
US

IV. Provider business mailing address

300 W CLARENDON AVE OFC NO3253
PHOENIX AZ
85013-3420
US

V. Phone/Fax

Practice location:
  • Phone: 571-734-7234
  • Fax:
Mailing address:
  • Phone: 571-734-7234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: NASAR KHAWAJA
Title or Position: CEO
Credential:
Phone: 571-734-7234