Provider Demographics
NPI:1689262396
Name:KIYATEC, INC
Entity Type:Organization
Organization Name:KIYATEC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PERREAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-412-4151
Mailing Address - Street 1:2 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4874
Mailing Address - Country:US
Mailing Address - Phone:864-502-2013
Mailing Address - Fax:864-502-2548
Practice Address - Street 1:2 N MAIN ST STE 167
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4874
Practice Address - Country:US
Practice Address - Phone:864-502-2013
Practice Address - Fax:864-502-2548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory