Provider Demographics
NPI:1023631595
Name:CATALYST DIAGNOSTIC LLC
Entity type:Organization
Organization Name:CATALYST DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMINAIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-885-3524
Mailing Address - Street 1:30600 TELEGRAPH RD STE 1395
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4530
Mailing Address - Country:US
Mailing Address - Phone:517-885-3524
Mailing Address - Fax:517-940-4260
Practice Address - Street 1:30600 TELEGRAPH RD STE 1395
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4530
Practice Address - Country:US
Practice Address - Phone:517-885-3524
Practice Address - Fax:517-940-4260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory