| Organization Name: | MISSOURI DIAGNOSTIC SERVICES, LLC |
| NPI Number: | 1215397153 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALEEM ABBASI (SECRETARY/ MEMBER) |
| Mailing Address: | 1517 Copper Rd Holts Summit |
| State: | MO US |
| Postal Code: | 650432033 |
| Phone Number: | 6602070031 |
| Fax Number: | 8776735233 |
| NPI Enumeration Date: | 03/04/2016 |
| NPI Last Update Date: | 03/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 293D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Physiological Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |