Healthcare Provider Details

I. General information

NPI: 1154554376
Provider Name (Legal Business Name): AMERICAN ULTRASOUND LAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2009
Last Update Date: 09/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 IDLEWILD DR UNIT 132
RENO NV
89509-1061
US

IV. Provider business mailing address

PO BOX 3564
RENO NV
89505-3564
US

V. Phone/Fax

Practice location:
  • Phone: 775-772-1266
  • Fax:
Mailing address:
  • Phone: 775-772-1266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. AJAY K SHARMA
Title or Position: MANAGER
Credential: RDCS, RVS, RCS
Phone: 775-772-1266