Healthcare Provider Details

I. General information

NPI: 1164188678
Provider Name (Legal Business Name): SWL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2021
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3117 SPRING GLEN RD STE 402
JACKSONVILLE FL
32207-5906
US

IV. Provider business mailing address

6859 LENOX AVE STE 18
JACKSONVILLE FL
32205-6149
US

V. Phone/Fax

Practice location:
  • Phone: 800-341-5024
  • Fax:
Mailing address:
  • Phone: 800-341-5024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY LEWIS
Title or Position: OWNER
Credential: CPT
Phone: 904-489-6974