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General NPI Number Information
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NPI Number | 1225278906
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Entity Type | Organization
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Legal Business Name | PHYSICIANS CHOICE LABORATORY SERVICES, LLC
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 07/24/2013
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Provider Practice Location Address
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Address Line | 854 PARAGON WAY
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City | ROCK HILL
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State | SC
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Zip | 29730-0005
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Country | US
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Telephone | 855-900-2927
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Fax | 980-318-5825
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Provider Business Mailing Address
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Address Line | 854 PARAGON WAY
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City | ROCK HILL
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State | SC
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Zip | 29730-0005
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Country | US
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Telephone | 855-900-2927
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Fax | 980-318-5825
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Authorized Official
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Title or Position | PRES/OPERATIONS
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Name | JOSEPH V WIEGEL
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Credential |
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Telephone | 803-325-9899
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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 | 34D1092392
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License Number State | NC
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