Provider Demographics
NPI:1568869055
Name:SCLTDI JV, LLC
Entity Type:Organization
Organization Name:SCLTDI JV, LLC
Other - Org Name:TOUCHSTONE IMAGING HIGHLINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-763-1112
Mailing Address - Street 1:700 E MOREHEAD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26 W DRY CREEK CIR
Practice Address - Street 2:SUITE 160
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8063
Practice Address - Country:US
Practice Address - Phone:720-889-2795
Practice Address - Fax:720-889-2812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory