Provider Demographics
NPI:1225278906
Name:PHYSICIANS CHOICE LABORATORY SERVICES, LLC
Entity Type:Organization
Organization Name:PHYSICIANS CHOICE LABORATORY SERVICES, LLC
Other - Org Name:PCLS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES/OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:V
Authorized Official - Last Name:WIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-325-9899
Mailing Address - Street 1:854 PARAGON WAY
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-0005
Mailing Address - Country:US
Mailing Address - Phone:855-900-2927
Mailing Address - Fax:980-318-5825
Practice Address - Street 1:854 PARAGON WAY
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-0005
Practice Address - Country:US
Practice Address - Phone:855-900-2927
Practice Address - Fax:980-318-5825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-20
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34D1092392291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory