Provider Demographics
NPI:1235768334
Name:CEDAR DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:CEDAR DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ATHANASSIOS
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAPAIOANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-916-3200
Mailing Address - Street 1:658 GRASSMERE PARK STE 104
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3683
Mailing Address - Country:US
Mailing Address - Phone:615-916-3200
Mailing Address - Fax:
Practice Address - Street 1:27B TALISMAN DR UNIT 3
Practice Address - Street 2:
Practice Address - City:PAGOSA SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81147-7914
Practice Address - Country:US
Practice Address - Phone:970-372-0456
Practice Address - Fax:970-507-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06D2176866OtherCLIA