Provider Demographics
NPI:1467106740
Name:FAITHMOBILE TESTING LLC
Entity Type:Organization
Organization Name:FAITHMOBILE TESTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:QUINERLY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-364-6790
Mailing Address - Street 1:101 S POINTE DR # B
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9947
Mailing Address - Country:US
Mailing Address - Phone:252-364-6790
Mailing Address - Fax:
Practice Address - Street 1:101 S POINTE DR # B
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-9947
Practice Address - Country:US
Practice Address - Phone:252-364-6790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory