Provider Demographics
NPI:1508669680
Name:INDEPENDENT SPECIMEN SERVICES LLC
Entity type:Organization
Organization Name:INDEPENDENT SPECIMEN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-413-0609
Mailing Address - Street 1:109 ANDERSON ST SE STE 105
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8610
Mailing Address - Country:US
Mailing Address - Phone:470-413-0609
Mailing Address - Fax:
Practice Address - Street 1:109 ANDERSON ST SE STE 105
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8610
Practice Address - Country:US
Practice Address - Phone:470-413-0609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory