| Name: | DOMINION DIAGNOSTICS, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 15 Dec 2010 (14 years ago) |
| Identification Number: | 000564713 |
| ZIP code: | 02852 |
| County: | Washington County |
| Place of Formation: | DELAWARE |
| Principal Address: | 211 CIRCUIT DRIVE, NORTH KINGSTOWN, RI, 02852, USA |
| Purpose: | LABORATORY |
| NAICS: | 621511 - Medical Laboratories |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912903717 | 2005-06-27 | 2022-12-14 | 211 CIRCUIT DRIVE, NORTH KINGSTOWN, RI, 028527440, US | 211 CIRCUIT DRIVE, NORTH KINGSTOWN, RI, 028527440, US | |||||||||||||||||||||||||||||||
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| Phone | +1 877-734-9600 |
| Fax | 4016670330 |
Authorized person
| Name | BRANDY ELLIS |
| Role | PAYER RELATIONS REP |
| Phone | 8027346392 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 00343 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CLIA |
| Number | 49D0926092 |
| Issuer | CAP AU-ID |
| Number | 1334975 |
| Issuer | CAP LAP NUMBER |
| Number | 7029901 |
| Name | Role | Address |
|---|---|---|
| MARK A. MCSALLY, ESQ. | Agent | 211 CIRCUIT DRIVE, NORTH KINGSTOWN, RI, 02852, USA |
| Number | Name | File Date |
|---|---|---|
| 202449606610 | Annual Report | 2024-03-27 |
| 202328788620 | Annual Report | 2023-02-18 |
| 202213120690 | Annual Report | 2022-03-20 |
| 202103058140 | Annual Report | 2021-10-12 |
| 202070656600 | Annual Report | 2020-11-01 |
| 201927099490 | Annual Report | 2019-11-06 |
| 201882678710 | Annual Report | 2018-12-15 |
| 201752440830 | Annual Report | 2017-10-31 |
| 201610309790 | Annual Report | 2016-10-13 |
| 201695818680 | Annual Report | 2016-04-12 |
Date of last update: 14 Oct 2024
Sources: Rhode Island Department of State
