Healthcare Provider Details

I. General information

NPI: 1104546415
Provider Name (Legal Business Name): RAPID RESPONSE TESTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 CREST AVE
SAINT LOUIS MO
63130-2604
US

IV. Provider business mailing address

6600 CREST AVE
SAINT LOUIS MO
63130-2604
US

V. Phone/Fax

Practice location:
  • Phone: 314-614-2991
  • Fax: 314-862-7523
Mailing address:
  • Phone: 314-614-2991
  • Fax: 314-862-7523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State

VIII. Authorized Official

Name: JOHONDA LAWANDA WILLIS
Title or Position: OWNER
Credential: RN
Phone: 314-614-2991