Organization
KEVIN CONCANNON LLC
Active
Other names
E. M. Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN HAGAN CONCANNON II CEO (OWNER)
(480) 939-4656
Entity
Organization
Contact information
Practice address
15455 N GREENWAY HAYDEN LOOP STE C16, SCOTTSDALE, AZ 85260-1886
(480) 939-4656
(480) 524-1070
Mailing address
15455 N GREENWAY HAYDEN LOOP STE C16, SCOTTSDALE, AZ 85260-1886
(480) 939-4656
(480) 524-1070
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03D2098042
CLIA
AZ
Enumeration date
04/28/2021
Last updated
04/28/2021
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