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General NPI Number Information
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NPI Number | 1518203777
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Entity Type | Organization
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Legal Business Name | DIAGNOVUS, LLC
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Dates
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Enumeration Date | 12/17/2012
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 336 HILL AVE SUITE 302
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City | NASHVILLE
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State | TN
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Zip | 37210-4712
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Country | US
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Telephone | 855-642-8438
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Fax | 855-893-9008
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Provider Business Mailing Address
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Address Line | 336 HILL AVE SUITE 302
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City | NASHVILLE
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State | TN
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Zip | 37210-4712
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Country | US
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Telephone | 855-642-8438
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES STOVER
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Credential | PH.D.
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Telephone | 615-351-1139
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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 | 44D2062333
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License Number State | TN
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