Provider Demographics
NPI:1043054570
Name:UNIVERSAL LABORATORY SERVICES, LLC
Entity type:Organization
Organization Name:UNIVERSAL LABORATORY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSTRUCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIMEN COLLECTOR
Authorized Official - Phone:843-621-0623
Mailing Address - Street 1:143 LONGSTREET CIR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30054-2247
Mailing Address - Country:US
Mailing Address - Phone:843-621-0623
Mailing Address - Fax:
Practice Address - Street 1:143 LONGSTREET CIR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:GA
Practice Address - Zip Code:30054-2247
Practice Address - Country:US
Practice Address - Phone:843-621-0623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty