Healthcare Provider Details
I. General information
NPI: 1245176601
Provider Name (Legal Business Name): DYNOVIA LLC
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
1500 N GRANT ST STE R
DENVER CO
80203-1859
US
IV. Provider business mailing address
1500 N GRANT ST STE R
DENVER CO
80203-1859
US
V. Phone/Fax
- Phone: 641-785-9377
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MUHAMMAD SAMEER
NASEER
Title or Position: OWNER
Credential:
Phone: 641-785-9377