Provider Demographics
NPI:1114318813
Name:PALMETTO DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:PALMETTO DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:CATONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-767-3985
Mailing Address - Street 1:1060 CHRIS CIR
Mailing Address - Street 2:SUITE D
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4773
Mailing Address - Country:US
Mailing Address - Phone:803-217-0105
Mailing Address - Fax:803-796-7846
Practice Address - Street 1:642 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-7346
Practice Address - Country:US
Practice Address - Phone:803-217-0105
Practice Address - Fax:035-267-3498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes293D00000XLaboratoriesPhysiological Laboratory
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty