Provider Demographics
NPI:1497581979
Name:SLM DRUG SCREENING SERVICES LLC
Entity type:Organization
Organization Name:SLM DRUG SCREENING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWANA
Authorized Official - Middle Name:LANITA
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-403-1385
Mailing Address - Street 1:113 S PERRY STREET SUITE 206 #8078
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046
Mailing Address - Country:US
Mailing Address - Phone:912-403-1385
Mailing Address - Fax:912-557-6039
Practice Address - Street 1:113 S PERRY STREET SUITE 206 #8078
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046
Practice Address - Country:US
Practice Address - Phone:912-403-1385
Practice Address - Fax:912-557-6039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty