Provider Demographics
NPI:1619738960
Name:TRUDIAGNOSTIC INC.
Entity Type:Organization
Organization Name:TRUDIAGNOSTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-797-2983
Mailing Address - Street 1:881 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2748
Mailing Address - Country:US
Mailing Address - Phone:859-797-2983
Mailing Address - Fax:
Practice Address - Street 1:881 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2748
Practice Address - Country:US
Practice Address - Phone:859-797-2983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory