Provider Demographics
NPI:1245999580
Name:KEIS TESTING, LLC
Entity type:Organization
Organization Name:KEIS TESTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THENELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-386-1101
Mailing Address - Street 1:506 DONOVAN ST
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-3149
Mailing Address - Country:US
Mailing Address - Phone:912-386-1011
Mailing Address - Fax:912-386-4743
Practice Address - Street 1:506 DONOVAN ST
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-3149
Practice Address - Country:US
Practice Address - Phone:912-386-1011
Practice Address - Fax:912-386-4743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty