Organization
KAN-DI-KI LLC
Active
Other names
Diagnostic Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN C CUOMO (CFO)
(800) 786-8015
Entity
Organization
Contact information
Practice address
3230 E. BROADWAY ROAD, SUITE 100, PHOENIX, AZ 85040-2874
(480) 967-2281
(480) 967-0306
Mailing address
215 SCHILLING CIR STE 114, HUNT VALLEY, MD 21031-1113
(800) 786-8015
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
03D2024612
AZ
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03D2024612
CLIA
AZ
05
—
619775
—
AZ
01
—
P01126484
RAILROAD MEDICARE
AZ
Enumeration date
06/07/2011
Last updated
03/13/2026
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