=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154876886
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRECISION MOLECULAR SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2016
-----------------------------------------------------
Last Update Date | 12/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 165 ASHLEY AVE # EH337
-----------------------------------------------------
City | CHARLESTON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29425-8905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-630-2225
-----------------------------------------------------
Fax | 866-645-9526
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 165 ASHLEY AVE # EH337
-----------------------------------------------------
City | CHARLESTON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29425-8905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-630-2225
-----------------------------------------------------
Fax | 866-645-9526
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING PARTNER
-----------------------------------------------------
Name | MR. JEREMY STUART
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 843-792-1912
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number | 42D2115298
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------