{"npi":"1104615673","type":"NPI-2","status":"active","name":{"display":"East Valley Diagnostics LLC","other":[],"organization_name":"EAST VALLEY DIAGNOSTICS LLC","authorised_official":"Jake Gabbard"},"specialty":{"primary_taxonomy":"291U00000X","primary_taxonomy_description":"Clinical Medical Laboratory","slug":"clinical-medical-laboratory","schema_org_specialty":"Pathology","all":[{"code":"291U00000X","description":"Clinical Medical Laboratory","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"2509 S POWER RD STE 105","city":"MESA","state":"AZ","postal_code":"852096696","country_code":"US","phone":"6236247420","fax":"6236247409"},{"purpose":"MAILING","street_1":"2509 S POWER RD STE 105","city":"MESA","state":"AZ","postal_code":"852096696","country_code":"US","phone":"6236247420","fax":"6236247409"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20250813001032","type_code":"12-69","type_desc":"PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY","state":"AZ","pac_id":"7911405444"}]},"enumeration_date":"2025-05-02","last_updated":"2025-11-03","_meta":{"source":"NPPES","snapshot_date":"2025-11-03","doc_url":"https://findmynpi.com/api"}}