Provider Demographics
NPI:1225305980
Name:HI TECH DIAGNOSTIC LLC
Entity Type:Organization
Organization Name:HI TECH DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:TANVEER
Authorized Official - Last Name:HAIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-222-3070
Mailing Address - Street 1:2 MONARCH TRACE CT
Mailing Address - Street 2:SUITE # 102
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4840
Mailing Address - Country:US
Mailing Address - Phone:636-222-3070
Mailing Address - Fax:
Practice Address - Street 1:2 MONARCH TRACE CT
Practice Address - Street 2:SUITE #102
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4840
Practice Address - Country:US
Practice Address - Phone:636-222-3070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory