MEDICARE: PARADIGM LABORATORIES, LLC

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
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1801291414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARADIGM LABORATORIES, LLC

Provider Business Mailing Address
First Line	:	6117 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5828
Country	:	US
Telephone Number	:	702-830-2823
Fax Number	:	520-901-2929

Provider Business Practice Location Address
First Line	:	6117 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5828
Country	:	US
Telephone Number	:	702-830-2823
Fax Number	:	520-901-2929

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. ETHAN C SASZ
Credential	:
Telephone Number	:	702-830-2823

Provider Enumeration Date	:	10/24/2014
Last Update Date	:	10/24/2014

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