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General NPI Number Information
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NPI Number | 1477334340
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Entity Type | Organization
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Legal Business Name | SHELTON DIAGNOSTICS INC
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Dates
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Enumeration Date | 10/09/2023
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 3320 PERIMETER HILL DR STE B
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City | NASHVILLE
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State | TN
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Zip | 37211-4123
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Country | US
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Telephone | 734-560-3254
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Fax | 906-828-1211
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Provider Business Mailing Address
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Address Line | 1311 S STEPHENSON AVE STE 3
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-4159
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Country | US
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Telephone | 734-560-3254
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Fax | 906-828-1211
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Authorized Official
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Title or Position | CEO
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Name | JAMIE SHELTON
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Credential |
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Telephone | 734-560-3254
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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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