Select Toxicology Labs, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SELECT TOXICOLOGY LABS, LLC

Practice address

1051 Bill Buyck Blvd
Manning, SC 29102-9242

Phone

(803) 505-6100

Fax

(803) 505-6130

NPI assigned

Nov 7, 2013

Last updated

Nov 7, 2013By 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

William Waddington

Title

President

Phone

(803) 505-6100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Select Toxicology Lab STL LLC

  • Clinical Medical Laboratory
  • Manning, SC
  • NPI 1952790206

  O20140222000198

  Same enrollment

Tax ID family

Select Toxicology Lab STL LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Select Toxicology Lab STL LLC

  • Clinical Medical Laboratory
  • Manning, SC
  • NPI 1952790206
  NPD tax ID

Locations

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1821427097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 BILL BUYCK BLVD",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291029242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 BILL BUYCK BLVD",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291029242",
            "telephone_number": "803-505-6100",
            "fax_number": "803-505-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT TOXICOLOGY LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "WADDINGTON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-505-6100"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SC Department of Juvenile Justice
• Kristen Scott, PHARMD
• Natalie Marie Scott, LMHC, LPC, MAC, CS
• Select Laboratories SC LLC
• Select Toxicology Lab STL LLC
• Courtney Sennett, OTR/L
• Jessica L Shanks
• John A. Sherman, MD
• Fantasia Trenell Singleton, LMSW
• Barbara Ann Slusher, PA, MSW

• Clinical Medical Laboratory in Manning, SC
• Providers in Manning, 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 Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.