Healthcare Provider Details

I. General information

NPI: 1073821310
Provider Name (Legal Business Name): SION FARM CLINICAL LABORATORY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2010
Last Update Date: 09/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 BEESTON HILL MEDICAL CTR
CHRISTIANSTED VI
00820-4885
US

IV. Provider business mailing address

4000 BEESTON HILL MEDICAL CTR
CHRISTIANSTED VI
00820-4885
US

V. Phone/Fax

Practice location:
  • Phone: 340-773-4990
  • Fax: 340-773-4990
Mailing address:
  • Phone: 340-773-4990
  • Fax: 340-773-4990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number48D1047502 (CLIA)
License Number StateVI

VIII. Authorized Official

Name: MS. CLAUDETTE G YOUNG HINDS
Title or Position: PRESIDENT/ OWNER
Credential: MCP
Phone: 340-773-4990