Healthcare Provider Details

I. General information

NPI: 1497726509
Provider Name (Legal Business Name): VALLEY DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 DEMERS AVE
GRAND FORKS ND
58201-4018
US

IV. Provider business mailing address

3035 DEMERS AVE
GRAND FORKS ND
58201-4018
US

V. Phone/Fax

Practice location:
  • Phone: 701-746-7521
  • Fax: 701-795-2553
Mailing address:
  • Phone: 701-746-7521
  • Fax: 701-795-2553

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: DR. BRIAN T BRIGGS
Title or Position: PRSEIDENT
Credential: MD
Phone: 701-746-7521