Provider Demographics
NPI:1386376549
Name:ALL QUALITY DIAGNOSTIC TESTING SERVICES LLC
Entity type:Organization
Organization Name:ALL QUALITY DIAGNOSTIC TESTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AQUANETTA
Authorized Official - Middle Name:LASHONDA
Authorized Official - Last Name:NESBITT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:843-598-5470
Mailing Address - Street 1:991 GRANDE LAWN LN
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6510
Mailing Address - Country:US
Mailing Address - Phone:843-598-5470
Mailing Address - Fax:
Practice Address - Street 1:105 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-2626
Practice Address - Country:US
Practice Address - Phone:843-598-5470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center