Provider Demographics
NPI:1902648504
Name:CALHOUN TESTING SERVICES 2
Entity type:Organization
Organization Name:CALHOUN TESTING SERVICES 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHADIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-387-7123
Mailing Address - Street 1:1060 STONEHAM CIR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29626-5676
Mailing Address - Country:US
Mailing Address - Phone:864-356-2799
Mailing Address - Fax:
Practice Address - Street 1:100 MIRACLE MILE DR STE D
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1300
Practice Address - Country:US
Practice Address - Phone:864-387-7123
Practice Address - Fax:864-359-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory