{"npi":"1487830733","type":"NPI-2","status":"active","name":{"display":"Celligent Diagnostics, LLC","other":[],"organization_name":"CELLIGENT DIAGNOSTICS, LLC","authorised_official":"Alfred Campbell"},"specialty":{"primary_taxonomy":"291U00000X","primary_taxonomy_description":"Clinical Medical Laboratory","slug":"clinical-medical-laboratory","schema_org_specialty":"Pathology","all":[{"code":"207ZP0101X","description":"Anatomic Pathology Physician","primary":false,"state":null,"license":null},{"code":"207ZP0102X","description":"Anatomic & Clinical Pathology","primary":false,"state":null,"license":null},{"code":"291U00000X","description":"Clinical Medical Laboratory","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"6135 LAKEVIEW RD STE 350","city":"CHARLOTTE","state":"NC","postal_code":"282692627","country_code":"US","phone":"7045498884","fax":"7045490559"},{"purpose":"MAILING","street_1":"PO BOX 96786","city":"CHARLOTTE","state":"NC","postal_code":"282966786","country_code":"US","phone":"7049735500","fax":"7049735518"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"7001318","state":"NC","issuer":null},{"type_code":"05","label":"Medicaid","value":"NPA737","state":"SC","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20100306000248","type_code":"12-69","type_desc":"PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY","state":"NC","pac_id":"3274619267"},{"enrlmt_id":"O20180815001262","type_code":"12-69","type_desc":"PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY","state":"SC","pac_id":"3274619267"}]},"enumeration_date":"2008-01-17","last_updated":"2024-11-18","_meta":{"source":"NPPES","snapshot_date":"2024-11-18","doc_url":"https://findmynpi.com/api"}}