PROMUS DIAGNOSTICS, LLC
NPI 1033680681
Clinical Medical Laboratory in Southlake, TX

NPI Status: Active since December 07, 2018

Contact Information

525 S KIMBALL AVE
SOUTHLAKE, TX
ZIP 76092
Phone: (817) 778-9210
Fax: (817) 778-9244

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  • Organization
  • Clinical Medical Laboratory
  • Accepts Insurance
  • CLIA Number: 45D2156626
  • CLIA Cert. Type: Independent
  • CLIA Exp. Date: 12-30-2027

About PROMUS DIAGNOSTICS, LLC

This page provides the complete NPI Profile along with additional information for Promus Diagnostics, Llc, a provider established in Southlake, Texas operating as a Clinical Medical Laboratory. The healthcare provider is registered in the NPI registry with number 1033680681 assigned on December 2018. The practitioner's primary taxonomy code is 291U00000X. The provider is registered as an organization and their NPI record was last updated March 2026. The authorized official of this NPI record is Mr. Victor Sansone Iii (Owner)

NPI
1033680681
Provider Name
PROMUS DIAGNOSTICS, LLC
Entity Type
Organization
Location Address
525 S KIMBALL AVE SOUTHLAKE, TX 76092
Location Phone
(817) 778-9210
Location Fax
(817) 778-9244
Mailing Address
525 S KIMBALL AVE SOUTHLAKE, TX 76092
Mailing Phone
(817) 778-9210
Mailing Fax
(817) 778-9244
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-07-2018
Last Update Date
03-26-2026
Code Navigator

Establishments like Promus Diagnostics, Llc are healthcare facilities that may perform a wide range of laboratory procedures, assisted by doctors and medical technologists. Laboratories can be categorized according to their function as common diagnostic labs or specialty labs that conduct specialized or confirmatory tests. Different clinical laboratories could specialize in clinical chemistry, clinical microbiology, hematology, serology, clinical microscopy, cytopathology, molecular biology, or public health. Please inquire directly with this provider to confirm their test menu.

Clinical labs in the U.S. that perform human testing are regulated by the Centers for Medicare & Medicaid Services (CMS) through the Clinical Laboratory Improvement Amendments (CLIA) program. The purpose of the CLIA program is to guarantee the quality of laboratory testing. This provider has a CLIA number assigned, and undergoes regular inspections to ensure compliance and quality.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinical Medical Laboratory

Taxonomy Code
291U00000X
Type
Laboratories
Taxonomy Description
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Bronze Neighborhood (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Silver Neighborhood (4 Free PCP Visits) - HMO
  • AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
  • AZ Blue EverydayHealth Gold Neighborhood (1 Free PCP Visit) - HMO
  • AZ Blue EverydayHealth Silver Focus (1 Free PCP Visit) - HMO
  • AZ Blue EverydayHealth Silver Neighborhood (1 Free PCP Visit) - HMO
  • AZ Blue Portfolio Bronze HSA Focus - HMO
  • AZ Blue Portfolio Bronze HSA Neighborhood - HMO
  • AZ Blue StandardHealth Bronze Focus - HMO
  • AZ Blue StandardHealth Bronze Neighborhood - HMO
  • AZ Blue StandardHealth Gold Focus - HMO
  • AZ Blue StandardHealth Gold Neighborhood - HMO
  • AZ Blue StandardHealth Silver Focus - HMO
  • AZ Blue StandardHealth Silver Neighborhood - HMO
  • BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. VICTOR SANSONE III

Authorized Official Title
OWNER
Authorized Official Phone
(817) 778-9210

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Detection test by nucleic acid for organism, amplified probe technique

A nucleic acid detection test is a procedure to identify specific organisms in your body. This test uses an amplified probe technique, which magnifies the genetic material of the organism, making it easier to detect. It's a precise way to diagnose infections.

This service was performed 6,617 times for 437 patients

Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique

A detection test for Staphylococcus aureus uses a method called the amplified probe technique. This method identifies the bacteria's unique genetic material, or nucleic acid, helping to confirm its presence. It's a highly accurate way to detect this type of bacteria.

This service was performed 509 times for 437 patients

Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique

A detection test by nucleic acid for MRSA bacteria uses an amplified probe technique. It's a lab procedure that identifies the presence of MRSA, a type of bacteria resistant to many antibiotics. This test helps in deciding the best treatment.

This service was performed 509 times for 437 patients

Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique

A detection test by nucleic acid for Group B Strep uses an amplified probe technique. This test identifies the presence of Group B Strep bacteria in the body. It involves collecting a sample, usually a swab, which is then examined in a lab for the bacteria's genetic material.

This service was performed 509 times for 437 patients

Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique

The detection test by nucleic acid for vancomycin-resistant strep (VRE) is a laboratory procedure. It uses an amplified probe technique to identify specific genetic material in bacteria. This helps determine if the bacteria are resistant to the antibiotic vancomycin.

This service was performed 509 times for 437 patients

Detection test for candida species (yeast), amplified probe technique

This test helps identify Candida, a type of fungus often present in the human body. An amplified probe technique is used, which enhances detection of the fungus in a sample. This method increases the accuracy of the test, helping to determine the best treatment.

This service was performed 2,032 times for 436 patients

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within

This is a test to detect the COVID-19 virus. It uses a technique that amplifies the virus's genetic material (DNA or RNA) for detection. High throughput technologies are used for rapid and large-scale testing. The procedure is completed within a set time frame.

This service was performed 209 times for 54 patients

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r

This is a test for COVID-19. It uses high-tech methods to find the virus's genetic material in your body. The amplified probe technique helps detect the virus even in small amounts. This is crucial for early detection and effective treatment.

This service was performed 209 times for 54 patients

Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source

Specimen collection for SARS-CoV-2, the virus causing COVID-19, involves taking a sample from the nose or throat using a swab. This sample is then analyzed in a lab to detect the presence of the virus. It's a crucial step in diagnosing COVID-19.

This service was performed 209 times for 54 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D2156626
Facility Type
Independent
Certificate Effective Date
December 31, 2025
Certificate Expiration Date
December 30, 2027
Laboratory Director
DR. PEJMAN RAHIMIAN
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Promus Diagnostics, Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

Reviews for PROMUS DIAGNOSTICS, LLC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1033680681, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
3
Doubled → 6
Pos 4
3
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
8
Unchanged
Pos 7
0
Doubled → 0
Pos 8
6
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 6 → 12 → 3 0 → 0 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 6 + 3 + 1 + 2 + 8 + 0 + 6 + 1 + 6 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1033680681.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033680681, enumerated as an "organization" on December 07, 2018.

The provider is located at 525 S KIMBALL AVE SOUTHLAKE, TX 76092 and the phone number is (817) 778-9210.

Clinical Medical Laboratory with taxonomy code 291U00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Blue Cross. Please consult your insurance carrier or call the provider to verify.