Healthcare Provider Details

I. General information

NPI: 1972611226
Provider Name (Legal Business Name): SOUTHWESTERN TESTING SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4140 SHERIDAN DR STE 3
WILLIAMSVILLE NY
14221-4341
US

IV. Provider business mailing address

4140 SHERIDAN DR STE 3
WILLIAMSVILLE NY
14221-4341
US

V. Phone/Fax

Practice location:
  • Phone: 716-204-4455
  • Fax: 716-204-4458
Mailing address:
  • Phone: 716-204-4455
  • Fax: 716-204-4458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. RADISLAV M LANKIN
Title or Position: PRESIDENT
Credential:
Phone: 716-204-4455