Test Well, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TEST WELL, LLC

Doing business as

Test Well

Practice address

1233 Ski Run Blvd # 4
South Lake Tahoe, CA 96150-7495

Phone

(530) 556-4226

NPI assigned

Jan 7, 2021

Last updated

Jan 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Boldwyn

Title

Managing Member

Phone

(530) 427-4163

Specialties & licenses 1

Addresses

Other names 1

• Test Well Doing business as

Locations

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1235727041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 ELKHORN BLVD # 7081",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958422526",
            "telephone_number": "530-556-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 SKI RUN BLVD # 4",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507495",
            "telephone_number": "530-556-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEST WELL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "BOLDWYN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "530-427-4163"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Test Well",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.