Provider Demographics
NPI:1437883584
Name:IT'S JUST BLOOD DIAGNOSTIC TESTING CENTER LLC
Entity Type:Organization
Organization Name:IT'S JUST BLOOD DIAGNOSTIC TESTING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:NICHELLE
Authorized Official - Last Name:MCMULLION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-415-8814
Mailing Address - Street 1:4531 BRICE BEND DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31601-0746
Mailing Address - Country:US
Mailing Address - Phone:229-415-8814
Mailing Address - Fax:
Practice Address - Street 1:1004 MARION ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-4029
Practice Address - Country:US
Practice Address - Phone:229-415-8814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service