NPI Code Detail JSON Logo

1023965738 NPI number — CRYSTAL CLEAR RESULTS LLC

NPI Number: 1023965738
Health Care Provider/Practitioner: CRYSTAL CLEAR RESULTS LLC

Information about “1023965738” NPI (CRYSTAL CLEAR RESULTS LLC) exists in 1023965738 in HTML format HTML  |  1023965738 in plain Text format TXT  |  1023965738 in PDF (Portable Document Format) PDF  |  1023965738 in an XML format XML  formats.

NPI Number : 1023965738 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023965738",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CRYSTAL CLEAR RESULTS LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "730 COURT ST STE B",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JACKSONVILLE",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28540-4814",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "866-476-8656",
    "MailingAddressFaxNumber": "866-476-8656",
    "FirstLinePracticeLocationAddress": "730 COURT ST STE B",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JACKSONVILLE",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28540-4814",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "866-476-8656",
    "PracticeLocationAddressFaxNumber": "866-476-8656",
    "EnumerationDate": "03/12/2026",
    "LastUpdateDate": "03/12/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GILL",
    "AuthorizedOfficialFirstName": "CRYSTAL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "GILL",
    "AuthorizedOfficialTelephoneNumber": "910-378-6662",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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