DIAGNOSTIC ENDOSCOPY LLC NPI 1689669418

Clinic/Center (Ambulatory Surgical) in Stamford, CT

NPI 1689669418 Organization Clinic/Center Ambulatory Surgical CLIA Number 07D0989155 CLIA Certificate of Waiver

About DIAGNOSTIC ENDOSCOPY LLC

Diagnostic Endoscopy Llc is a provider established in Stamford, Connecticut specializing in clinic/center (ambulatory surgical) . The NPI number of Diagnostic Endoscopy Llc is 1689669418 and was assigned on September 2005. The practitioner's primary taxonomy code is 261QA1903X with license number 0301 (CT). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Mr. Phillip A. Clendenin (President)

The CLIA number of Diagnostic Endoscopy Llc is 07D0989155 registered as a "ambulatory surgery center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Diagnostic Endoscopy Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1689669418

Provider NameDIAGNOSTIC ENDOSCOPY LLC
Provider Location Address778 LONG RIDGE RD STAMFORD, CT 06902
Provider Mailing Address778 LONG RIDGE RD STAMFORD, CT 06902
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-19-2005
Last Update Date06-27-2016


Primary Taxonomy

Taxonomy Code261QA1903X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationAmbulatory Surgical
License No.0301
License StateCT

Business Address

DIAGNOSTIC ENDOSCOPY LLC
778 LONG RIDGE RD
STAMFORD, CT
ZIP 06902
Phone: (203) 322-2400
Fax: (203) 329-8855

Get Directions


Mailing Address

DIAGNOSTIC ENDOSCOPY LLC
778 LONG RIDGE RD
STAMFORD, CT
ZIP 06902
Phone: (203) 322-2400
Fax: (203) 329-8855



Authorized Official

Authorized Official NameMR. PHILLIP A. CLENDENIN
Authorized Official TitlePRESIDENT
Authorized Official Phone(615) 665-1283

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 the NPI number 1689669418 is:

CLIA Number07D0989155
Facility TypeAMBULATORY SURGERY CENTER
Certificate TypeCertificate of Waiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
A2535749OTHER (01)
IV8574OTHER (01)
07AOTHER (01)
490000226MEDICARE PIN (08)CT
747394OTHER (01)
7189280OTHER (01)

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1669703021PEYSER CHIROPRACTIC
Organization
Chiropractor778 LONG RIDGE RD SUITE 2
STAMFORD, CT 06902
(203) 329-7122
1942622378AMSURG STAMFORD ANESTHESIA LLC
Organization
Anesthesiology778 LONG RIDGE RD
STAMFORD, CT 06902
(203) 322-2400
1053524876GASTROENTEROLOGY CONSULTANTS, P.C.
Organization
Internal Medicine (Gastroenterology)778 LONG RIDGE RD SUITE 101
STAMFORD, CT 06902
(203) 967-2100
1356492755THE NEW ENGLAND CENTER FOR HEADACHE
Organization
Specialist778 LONG RIDGE RD
STAMFORD, CT 06902
(203) 968-1799

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.