Provider Demographics
NPI:1801291414
Name:PARADIGM LABORATORIES, LLC
Entity type:Organization
Organization Name:PARADIGM LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SASZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-830-2823
Mailing Address - Street 1:6117 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-5828
Mailing Address - Country:US
Mailing Address - Phone:702-830-2823
Mailing Address - Fax:520-901-2929
Practice Address - Street 1:6117 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-5828
Practice Address - Country:US
Practice Address - Phone:702-830-2823
Practice Address - Fax:520-901-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory