Provider Demographics
NPI:1659143899
Name:COMPLETE DIAGNOSTIC LABORATORIES, LLC
Entity Type:Organization
Organization Name:COMPLETE DIAGNOSTIC LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/ CHIEF SCIENTIFIC OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:BUDD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:662-350-0923
Mailing Address - Street 1:211 SUMMIT PKWY STE 114
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4742
Mailing Address - Country:US
Mailing Address - Phone:662-350-0923
Mailing Address - Fax:662-350-0923
Practice Address - Street 1:7065 AIRWAYS BLVD STE 109
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-5862
Practice Address - Country:US
Practice Address - Phone:662-350-0923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory