The Lab Columbia LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

THE LAB COLUMBIA LLC

Practice address

11134 Broad River Rd
Ste B PMB 1004
Irmo, SC 29063

Phone

(314) 888-5630

Fax

(314) 293-6711

NPI assigned

Nov 27, 2023

Organization subpart

No

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

Authorized official

Name

Shaquana Thompson

Title

Business Co-Owner

Phone

(314) 888-5630

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1326814922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11134 BROAD RIVER RD",
            "address_2": "STE B PMB 1004",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "29063",
            "telephone_number": "314-888-5630",
            "fax_number": "314-293-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11134 BROAD RIVER RD",
            "address_2": "STE B PMB 1004",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "29063",
            "telephone_number": "314-888-5630",
            "fax_number": "314-293-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LAB COLUMBIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "SHAQUANA",
        "authorized_official_title_or_position": "BUSINESS CO-OWNER",
        "authorized_official_telephone_number": "314-888-5630"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.