A laboratory that operates independently of a hospital and physician?s office to furnish physiological diagnostic services (e.g. EEG?s , EKG?s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Physiological Laboratory, (Independent Physiological Lab) | 293D00000X |
| Internal Medicine | 207R00000X |
* Indicates primary specialty
| NPI Number | 1619097805 |
| Credentials | MD |
| Entity | Individual |
| Enumeration date | 03/30/2007 |
| Last updated | 02/18/2026 - About 4 months ago |
| Sole proprietor1 | Yes |
| Identifiers |
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| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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