Provider Demographics
NPI:1306107461
Name:SCITEST LABORATORIES INC
Entity type:Organization
Organization Name:SCITEST LABORATORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:804-464-8750
Mailing Address - Street 1:1551 OAKBRIDGE DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139
Mailing Address - Country:US
Mailing Address - Phone:804-464-8750
Mailing Address - Fax:
Practice Address - Street 1:1551 OAKBRIDGE DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139
Practice Address - Country:US
Practice Address - Phone:804-464-8750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory