MEDICARE: SOUTHWESTERN TESTING SERVICE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471V0105X	Vascular Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1972611226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWESTERN TESTING SERVICE, INC.

Provider Business Mailing Address
First Line	:	4140 SHERIDAN DR STE 3
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-4341
Country	:	US
Telephone Number	:	716-204-4455
Fax Number	:	716-204-4458

Provider Business Practice Location Address
First Line	:	4140 SHERIDAN DR STE 3
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-4341
Country	:	US
Telephone Number	:	716-204-4455
Fax Number	:	716-204-4458

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RADISLAV M LANKIN
Credential	:
Telephone Number	:	716-204-4455

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	08/22/2020

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