Provider Demographics
NPI:1437605615
Name:PHI LIFE SCIENCES LLC
Entity Type:Organization
Organization Name:PHI LIFE SCIENCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-752-3553
Mailing Address - Street 1:645 MEETING ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-4279
Mailing Address - Country:US
Mailing Address - Phone:888-576-5445
Mailing Address - Fax:888-738-2470
Practice Address - Street 1:645 MEETING ST
Practice Address - Street 2:SUITE 3
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-4279
Practice Address - Country:US
Practice Address - Phone:888-576-5445
Practice Address - Fax:888-738-2470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic PathologyGroup - Multi-Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Multi-Specialty