Provider Demographics
NPI:1073821310
Name:SION FARM CLINICAL LABORATORY, INC.
Entity Type:Organization
Organization Name:SION FARM CLINICAL LABORATORY, INC.
Other - Org Name:BEESTON HILL CLINICAL LAB
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAUDETTE
Authorized Official - Middle Name:G
Authorized Official - Last Name:YOUNG HINDS
Authorized Official - Suffix:
Authorized Official - Credentials:MCP
Authorized Official - Phone:340-773-4990
Mailing Address - Street 1:4000 BEESTON HILL MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-4885
Mailing Address - Country:US
Mailing Address - Phone:340-773-4990
Mailing Address - Fax:340-773-4990
Practice Address - Street 1:4000 BEESTON HILL MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4885
Practice Address - Country:US
Practice Address - Phone:340-773-4990
Practice Address - Fax:340-773-4990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI48D1047502 (CLIA)291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory