Provider Demographics
NPI:1659240430
Name:PURE TEST DIAGNOSTICS LAB LLC
Entity type:Organization
Organization Name:PURE TEST DIAGNOSTICS LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAHZAIB
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-232-8951
Mailing Address - Street 1:1905 N SHERMAN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-1132
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 N PEARL ST OFFICE 107
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203
Practice Address - Country:US
Practice Address - Phone:267-232-8951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-31
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No291U00000XLaboratoriesClinical Medical Laboratory