Inmed Diagnostics Services of SC LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

42D1057507 Issued in SC

Legal business name

INMED DIAGNOSTICS SERVICES OF SC LLC

Practice address

811 82ND Pkwy Ste D
Myrtle Beach, SC 29572-4653

Phone

(843) 692-0040

Fax

(843) 692-0046

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Carmen Restivo

Title

Credentialing Manager

Phone

(352) 241-6100

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1356546659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 593869",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328593869",
            "telephone_number": "352-241-6100",
            "fax_number": "352-241-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 82ND PKWY STE D",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724653",
            "telephone_number": "843-692-0040",
            "fax_number": "843-692-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INMED DIAGNOSTICS SERVICES OF SC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "RESTIVO",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "352-241-6100"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "SC",
            "license": "42D1057507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Myrtle Beach, SC by specialty
• Clinical Medical Laboratory in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.