ARIZONA INDEPENDENT DIAGNOSTIC TESTING FACILITY PLLC – NPI #1205422367
Physiological Laboratory

A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.

ARIZONA INDEPENDENT DIAGNOSTIC TESTING FACILITY PLLC is a physiological laboratory located in PHOENIX, AZ. NPPES has assigned the NPI number 1205422367 to ARIZONA INDEPENDENT DIAGNOSTIC TESTING FACILITY PLLC on December 14, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 293D00000X from the Health Care Provider Taxonomy code set, which is classified as Physiological Laboratory.

The NPI profile was previously updated about 5 years ago on Dec 15, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ARIZONA INDEPENDENT DIAGNOSTIC TESTING FACILITY PLLC below.

NPI Profile for
ARIZONA INDEPENDENT DIAGNOSTIC TESTING FACILITY PLLC

NPI Number
1205422367
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ARIZONA INDEPENDENT DIAGNOSTIC TESTING FACILITY PLLC
Primary location
8618 N 35TH AVE STE 3
PHOENIX, AZ 85051-3800
Phone: (602) 821-4517 Fax:
Mailing address
8660 S PEORIA AVE
TULSA, OK 74132-2827
Phone: Fax:
Organization Subpart
No
Authorized Official
JEFF BROUWER
MANAGING MEMBER
Phone: (602) 821-4517
Updated
Certification Date
Dec 15, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
293D00000X
- Physiological Laboratory (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.