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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 | Specialty Code | Provider Type | |
Physiological Laboratory, (Independent Physiological Lab) |
293D00000X | 47 | Independent Diagnostic Testing Facility (IDTF) |
| NPI # | 1831869023 |
| LBN Legal business name | PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC. |
| Authorized official | BRUCE JOHNSON - (VP-AO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/17/2021 |
| Last updated | 03/31/2025 - More than a year ago |
| Identifiers | n/a |
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| PETER E CARRA, OD 10TH MEDICAL GROUP AF ACADEMY, CO |
| AGATE FIRE PROTECTION DISTRICT 40160 COUNTY ROAD 153 AGATE, CO |
| HANNAH L BEAL MALOTT, MD 10TH MEDICAL GROUP 4102 PINION DRIVE 719-524-2273, CO |
| COLLABORATIVE JOURNEYS, LLC 36533 COUNTY ROAD 153 AGATE, CO |
| LISA M PEREZ, APN 725 S 4TH STREET 9702407734, CO |
PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC.