=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861175945
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAMDEN COMPLIANCE LABS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2023
-----------------------------------------------------
Last Update Date | 09/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3028 PORTER RD
-----------------------------------------------------
City | CAMDEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08104-2709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-437-8672
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3028 PORTER RD
-----------------------------------------------------
City | CAMDEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08104-2709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-820-4394
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JAMILA BOWMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 609-820-4394
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------