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General NPI Number Information
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NPI Number | 1346600731
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Entity Type | Organization
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Legal Business Name | Z3 DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 1485 LIVINGSTON LN
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City | JACKSON
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State | MS
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Zip | 39213-8004
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Country | US
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Telephone | 601-214-6181
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Fax |
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Provider Business Mailing Address
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Address Line | 1485 LIVINGSTON LN
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City | JACKSON
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State | MS
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Zip | 39213-8004
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Country | US
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Telephone | 601-214-6181
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL DIRECTOR
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Name | DR. SHAHJAHAN SULTAN
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Credential | M.D.
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Telephone | 412-721-2417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 21500
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License Number State | MS
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