NPI age
19 years
Enumerated 2007-02-23
● Active Type 2 · Organization
Stat Diagnostic Lab Llc
Stat Diagnostic Lab Llc is 1 of 2082 clinical medical laboratory organizations in Texas.
Primary specialty
Clinical Medical Laboratory
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Booker
President
Last NPPES update
2008-06-05
Source: monthly bulk 2026-05
How this organization compares
Across 2082 active clinical medical laboratory providers in Texas.
NPI age
19 years
↑ 11 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-02Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
509 N Hampton Rd, Suite 204
Desoto, TX 751154970
Mailing address
4515 Colonial Ave
Dallas, TX 752154140
Authorized official
Delia Delores Booker
President
📞 2144344032
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Ayodele Fadahunsi, D.C. Chiropractor NPI 1376921270
- Danika Mamon, D.C. Chiropractor NPI 1932565462
Specialties
-
Clinical Medical Laboratory Primary(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (MD) | 20449 | CLIA |
| 01 (TX) | 45D1064567 | CLIA |
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.