=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255943155
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. KIEARA ONYIA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2020
-----------------------------------------------------
Last Update Date | 04/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 313 N GILBERT RD STE 300
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85234-5998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-799-7267
-----------------------------------------------------
Fax | 480-808-4089
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 313 N GILBERT RD STE 300
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85234-5998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-799-7267
-----------------------------------------------------
Fax | 480-808-4089
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 246Q00000X
-----------------------------------------------------
Taxonomy Name | Pathology Specialist/Technologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------