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General NPI Number Information
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NPI Number | 1609718360
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Entity Type | Organization
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Legal Business Name | MEDLINQ DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 04/09/2026
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Last Update Date | 04/09/2026
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Provider Practice Location Address
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Address Line | 10011 SOUTHMOOR LN
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City | FORT MILL
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State | SC
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Zip | 29707-9117
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Country | US
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Telephone | 800-536-0077
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Fax | 704-276-6444
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Provider Business Mailing Address
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Address Line | 10011 SOUTHMOOR LN
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City | FORT MILL
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State | SC
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Zip | 29707-9117
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Country | US
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Telephone | 800-536-0077
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Fax | 704-276-6444
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Authorized Official
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Title or Position | CEO
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Name | SERGIO KHOMYAK
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Credential | RDMS, RVT
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Telephone | 704-390-6607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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