| 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 LaboratoriesThis U.S. industry comprises establishments known as medical laboratories primarily engaged in providing analytic or diagnostic services, including body fluid analysis, generally to the medical profession or to the patient on referral from a health practitioner. Learn more at the U.S. Census Bureau
| 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
