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NPI Code Detail

MEDICARE: UNIVERSAL DIAGNOSTIC SERVICES INC

MEDICARE: UNIVERSAL DIAGNOSTIC SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1235070673
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSAL DIAGNOSTIC SERVICES INC
Provider Business Mailing Address
First Line : 199 NORTH LAKE DRIVE
Second Line : SUITE 105
City : PRESTONSBURG
State : KY
Zip : 41653
Country : US
Telephone Number : 606-793-4510
Fax Number :
Provider Business Practice Location Address
First Line : 199 NORTH LAKE DRIVE
Second Line : SUITE 105
City : PRESTONSBURG
State : KY
Zip : 41653
Country : US
Telephone Number : 606-886-8889
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : SANJAY SRIVASTAVA
Credential :
Telephone Number : 606-793-4510
Provider Enumeration Date : 04/01/2026
Last Update Date : 04/01/2026

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Directions to “UNIVERSAL DIAGNOSTIC SERVICES INC ” Practice Location

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