Healthcare Provider Details

I. General information

NPI: 1063811941
Provider Name (Legal Business Name): PRECISION DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 05/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 E 86TH ST STE 72F
INDIANAPOLIS IN
46240-1862
US

IV. Provider business mailing address

PO BOX 856300 DEPT 148
LOUISVILLE KY
40285-6300
US

V. Phone/Fax

Practice location:
  • Phone: 866-363-0203
  • Fax: 866-285-6850
Mailing address:
  • Phone: 866-363-0203
  • Fax: 866-285-6850

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: NATHAN SCHAFFNER
Title or Position: VICE PRESIDENT OF SALES
Credential:
Phone: 317-218-3476