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

Active since December 07, 2018CLIA 45D2156626 · Accreditation
525 S KIMBALL AVE, SOUTHLAKE, TX 76092(817) 778-9210(817) 778-9244 Get Directions Write a Review

NPPES record last updated: March 26, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 26, 2026, May 8, 2025, Oct 10, 2023 and 2 more (5 updates tracked since 2018).

About Promus Diagnostics, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROMUS DIAGNOSTICS, LLC (NPI 1033680681) is a healthcare organization registered as a clinical medical laboratory in Southlake, Texas and active in the NPI registry since December 2018. The organization holds an CLIA Accreditation certificate valid through December 30, 2027 and lists Victor Sansone, Owner, as its authorized official.

NPPES Registry Identity

NPI1033680681
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NamePROMUS DIAGNOSTICS, LLC
Location Address525 S KIMBALL AVESouthlake, TX 76092-8064
Mailing Address525 S Kimball AveSouthlake, TX 76092-8064 · (817) 778-9210 · Fax (817) 778-9244
Fax(817) 778-9244
Organization SubpartNo
Authorized OfficialVictor SansoneOwner · (817) 778-9210
Enumeration DateDecember 7, 2018
Last NPPES UpdateMarch 26, 20265 updates tracked since enumeration
NPPES CertifiedMarch 26, 2026
NPI 1033680681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition

(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.

525 S KIMBALL AVE, Southlake, TX 76092

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 45D2156626

Promus Diagnostics, LLC · Southlake, TX
Active · expires Dec 30, 2027
CLIA Number45D2156626
Laboratory TypeIndependent
Certificate Effective DateDecember 31, 2025
Certificate Expiration DateDecember 30, 2027
Laboratory DirectorDr. Pejman Rahimian
Laboratory Phone(817) 778-9210
Laboratory LocationPromus Diagnostics, LLC525 S Kimball Ave, Southlake, TX 76092
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Promus Diagnostics, LLC's NPI number?

The NPI number for Promus Diagnostics, LLC is 1033680681. It was assigned to this organization in the NPPES registry on December 7, 2018.

Where is Promus Diagnostics, LLC located?

Promus Diagnostics, LLC is located at 525 S Kimball Ave, Southlake, TX 76092. The listed phone number is (817) 778-9210.

What is Promus Diagnostics, LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Promus Diagnostics, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 45D2156626) is associated with this NPI, valid through December 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Promus Diagnostics, LLC accept?

Health plans from Blue Cross Blue Shield of Arizona, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee list Promus Diagnostics, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Promus Diagnostics, LLC was last updated on March 26, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.