Provider Demographics
NPI:1275576597
Name:AFFINITY DIAGNOSTIC SERVICES LLC
Entity Type:Organization
Organization Name:AFFINITY DIAGNOSTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANALOVITCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-567-6737
Mailing Address - Street 1:3501 W 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4423
Mailing Address - Country:US
Mailing Address - Phone:303-567-6737
Mailing Address - Fax:303-234-0124
Practice Address - Street 1:3501 W 23RD AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4423
Practice Address - Country:US
Practice Address - Phone:303-567-6737
Practice Address - Fax:303-234-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO805195Medicare PIN