Provider Demographics
NPI:1497293773
Name:INVISION DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:INVISION DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-318-1349
Mailing Address - Street 1:11220 ELM LN STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0450
Mailing Address - Country:US
Mailing Address - Phone:778-318-1349
Mailing Address - Fax:704-966-2407
Practice Address - Street 1:11220 ELM LN STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-0450
Practice Address - Country:US
Practice Address - Phone:704-624-6228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile Mammography
No293D00000XLaboratoriesPhysiological Laboratory
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNPC187Medicaid
NC1497293773Medicaid