Healthcare Provider Details

I. General information

NPI: 1497197321
Provider Name (Legal Business Name): AMERICAN DRUG TESTING LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 HARLEY ST
SCOTTSBORO AL
35768-4219
US

IV. Provider business mailing address

PO BOX 56
SCOTTSBORO AL
35768-0056
US

V. Phone/Fax

Practice location:
  • Phone: 256-259-1886
  • Fax:
Mailing address:
  • Phone: 256-259-1886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateAL

VIII. Authorized Official

Name: MS. DIANE RICE
Title or Position: OFFICE MANAGER
Credential:
Phone: 256-259-1886