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General NPI Number Information
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NPI Number | 1366219917
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Entity Type | Organization
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Legal Business Name | VIDA SCREENING LLC
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Dates
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Enumeration Date | 12/05/2023
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 2200 US HIGHWAY 98 STE 4 - 175
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City | DAPHNE
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State | AL
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Zip | 36526-4395
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Country | US
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Telephone | 251-298-4236
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 US HIGHWAY 98 STE 4
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City | DAPHNE
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State | AL
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Zip | 36526-4382
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | PIO GUZMAN
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Credential |
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Telephone | 251-298-4236
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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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