Healthcare Provider Details
I. General information
NPI: 1952195091
Provider Name (Legal Business Name): DISCOVERY DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/05/2025
Last Update Date: 04/05/2025
Certification Date: 04/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9610 TWO NOTCH RD STE 8
COLUMBIA SC
29223-1601
US
IV. Provider business mailing address
136 THOMASTON DR
COLUMBIA SC
29229-8191
US
V. Phone/Fax
- Phone: 803-380-8211
- Fax: 839-213-4908
- Phone: 803-563-1134
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
KENDRA
HARLEY
Title or Position: OWNER
Credential:
Phone: 803-380-8211