Healthcare Provider Details

I. General information

NPI: 1336009778
Provider Name (Legal Business Name): ACME DIAGNOSTIC LABORATORY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 11/17/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 LUISA ST STE J
SANTA FE NM
87505-4073
US

IV. Provider business mailing address

1421 LUISA ST STE J
SANTA FE NM
87505-4073
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-8338
  • Fax:
Mailing address:
  • Phone: 505-570-5570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2279P1006X
TaxonomyPulmonary Function Technologist Registered Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN CASKEY
Title or Position: OWNER/MANAGING MEMBER
Credential: MD
Phone: 505-982-8338