MEDICARE: SWL SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician
2	291U00000X	Clinical Medical Laboratory

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164188678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWL SERVICES LLC

Provider Business Mailing Address
First Line	:	6859 LENOX AVE STE 18
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-6149
Country	:	US
Telephone Number	:	800-341-5024
Fax Number	:

Provider Business Practice Location Address
First Line	:	3117 SPRING GLEN RD STE 402
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5906
Country	:	US
Telephone Number	:	800-341-5024
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	COURTNEY LEWIS
Credential	:	CPT
Telephone Number	:	904-489-6974

Provider Enumeration Date	:	11/10/2021
Last Update Date	:	02/08/2023

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Directions to “SWL SERVICES LLC ” Practice Location

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