Healthcare Provider Details

I. General information

NPI: 1699601856
Provider Name (Legal Business Name): FORTUITY FLOW LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 HILLCREST DR
LAURENS SC
29360-2340
US

IV. Provider business mailing address

112 HILLCREST DR
LAURENS SC
29360-2340
US

V. Phone/Fax

Practice location:
  • Phone: 864-810-6772
  • Fax:
Mailing address:
  • Phone: 864-810-6772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIE WEBB
Title or Position: OWNER/DIRECTOR
Credential: CPT
Phone: 864-810-6772