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General NPI Number Information
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NPI Number | 1215899885
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Entity Type | Organization
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Legal Business Name | DNA TESTING ASSOCIATES
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 117 ALPINE CIR STE 600-D
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City | COLUMBIA
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State | SC
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Zip | 29223-6523
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Country | US
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Telephone | 803-400-8752
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Fax | 803-403-0361
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Provider Business Mailing Address
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Address Line | 117 ALPINE CIR STE 600-D
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City | COLUMBIA
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State | SC
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Zip | 29223-6523
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Country | US
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Telephone | 803-400-8752
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Fax | 803-403-0361
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Authorized Official
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Title or Position | CEO
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Name | WILLIE DEMETRIUS BURRELL
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Credential |
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Telephone | 803-400-8752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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