Tanisha Shuante Riles

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Practice address

702 Van Streat Hwy
Nicholls, GA 31554-4017

Phone

(912) 501-4094

Fax

(708) 367-6703

NPI assigned

Oct 22, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• SLB Diagnostic Solution LLC

  • Clinical Medical Laboratory
  • Nicholls, GA
  • NPI 1184592677
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1124995147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 VAN STREAT HWY",
            "city": "NICHOLLS",
            "state": "GA",
            "postal_code": "315544017",
            "telephone_number": "912-501-4094",
            "fax_number": "708-367-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 VAN STREAT HWY",
            "city": "NICHOLLS",
            "state": "GA",
            "postal_code": "315544017",
            "telephone_number": "912-501-4094",
            "fax_number": "708-367-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILES",
        "first_name": "TANISHA",
        "middle_name": "SHUANTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad M Mobley, PHARMOCIST
• Nicholls Clinic
• Nicholls Family Health Care, P.C.
• Nicholls Pharmacy
• Nicholls Pharmacy LLC
• Hope Elizabeth Schermerhorn, CNA
• Myra Sellers, CCC-SLP
• SLB Diagnostic Solution LLC
• South East EMS LLC (South East EMS)
• Richard Kevin Tanner

• Clinical Medical Laboratory in Nicholls, GA
• Providers in Nicholls, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.