Provider Demographics
NPI:1134479793
Name:AMERICAN HOME DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:AMERICAN HOME DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:G
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-916-4433
Mailing Address - Street 1:7575 N CEDAR AVE
Mailing Address - Street 2:103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2693
Mailing Address - Country:US
Mailing Address - Phone:559-916-4433
Mailing Address - Fax:
Practice Address - Street 1:7575 N CEDAR AVE
Practice Address - Street 2:103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2693
Practice Address - Country:US
Practice Address - Phone:559-916-4433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No291U00000XLaboratoriesClinical Medical Laboratory