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General NPI Number Information
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NPI Number | 1548517758
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Entity Type | Organization
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Legal Business Name | DRUG TESTING SERVICE CENTER
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 08/07/2012
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Provider Practice Location Address
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Address Line | 10011 PINES BLVD SUITE 202
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6189
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Country | US
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Telephone | 954-430-2676
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Fax | 954-430-2891
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Provider Business Mailing Address
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Address Line | PO BOX 870115
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-0003
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Country | US
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Telephone | 770-985-1888
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Fax | 866-799-3188
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. SHARON DAVIS
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Credential |
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Telephone | 954-430-2676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | 20090494
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License Number State | FL
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