Healthcare Provider Details

I. General information

NPI: 1386540979
Provider Name (Legal Business Name): MEDLEY TESTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2026
Last Update Date: 10/19/2026
Certification Date: 10/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9104 DORSEY ST
SPRING HILL FL
34608-5343
US

IV. Provider business mailing address

4210 COMMERCIAL WAY
SPRING HILL FL
34606-2325
US

V. Phone/Fax

Practice location:
  • Phone: 386-262-6749
  • Fax:
Mailing address:
  • Phone: 386-262-6749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number State

VIII. Authorized Official

Name: SELENA JENNINGS
Title or Position: OWNER
Credential: COLLECTOR /TRANIER
Phone: 386-262-6749