Premium Labs LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

PREMIUM LABS LLC

Practice address

6729 Two Notch Rd Ste 130
Columbia, SC 29223-7535

Phone

(803) 398-9500

NPI assigned

Feb 13, 2023

Organization subpart

No

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

Authorized official

Name

Keyanne Holmes

Title

Director of Opertations

Phone

(803) 398-9500

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": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1649977398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6729 TWO NOTCH RD STE 130",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292237535",
            "telephone_number": "803-398-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6729 TWO NOTCH RD STE 130",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292237535",
            "telephone_number": "803-398-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "KEYANNE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERTATIONS",
        "authorized_official_telephone_number": "803-398-9500"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Columbia, SC
• Providers in Columbia, SC by specialty
• Point of Service in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.