Provider Demographics
NPI:1427758093
Name:KISMET SCREENING LABS LLC
Entity type:Organization
Organization Name:KISMET SCREENING LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-880-9769
Mailing Address - Street 1:5008 29TH AVE UNIT 3574
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39303-5018
Mailing Address - Country:US
Mailing Address - Phone:601-816-8777
Mailing Address - Fax:601-640-4013
Practice Address - Street 1:1410 14TH ST STE A
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4202
Practice Address - Country:US
Practice Address - Phone:601-816-8777
Practice Address - Fax:601-640-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory