MEDICARE: RICHARD BERNERT, 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	31463	AZ

General Provider Information

NPI Number	:	1912234618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD BERNERT, LLC

Provider Business Mailing Address
First Line	:	1355 RIVER BEND DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4915
Country	:	US
Telephone Number	:	214-237-1818
Fax Number	:	844-751-9263

Provider Business Practice Location Address
First Line	:	9060 E VIA LINDA STE 115
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-5422
Country	:	US
Telephone Number	:	480-206-9091
Fax Number	:	480-772-4296

Authorized Official
Title or Position	:	SENIOR DIRECTOR
Name	:	DINA VALLADARES
Credential	:
Telephone Number	:	954-803-9405

Provider Enumeration Date	:	11/17/2009
Last Update Date	:	04/07/2026

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