Healthcare Provider Details

I. General information

NPI: 1609712298
Provider Name (Legal Business Name): PASHA DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4616 N 51ST AVE STE 214
PHOENIX AZ
85031-1716
US

IV. Provider business mailing address

4616 N 51ST AVE STE 214
PHOENIX AZ
85031-1716
US

V. Phone/Fax

Practice location:
  • Phone: 254-749-7016
  • Fax:
Mailing address:
  • Phone:
  • 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: MR. KHAJA PASHA
Title or Position: OWNER
Credential:
Phone: 254-749-7016