Healthcare Provider Details

I. General information

NPI: 1922855196
Provider Name (Legal Business Name): SINCERE AND TRUE DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2024
Last Update Date: 05/04/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24195 LOTUS DR APT 302
CLINTON TOWNSHIP MI
48036-4305
US

IV. Provider business mailing address

24195 LOTUS DR APT 302
CLINTON TOWNSHIP MI
48036-4305
US

V. Phone/Fax

Practice location:
  • Phone: 800-567-0445
  • Fax:
Mailing address:
  • Phone: 800-567-0445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: QUINZELLA POWELL
Title or Position: OWNER
Credential:
Phone: 800-567-0445