Provider Demographics
NPI:1144460908
Name:DRUG TESTING LLC
Entity type:Organization
Organization Name:DRUG TESTING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOBASKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-536-2967
Mailing Address - Street 1:45 SW SEMINOLE ST
Mailing Address - Street 2:APT 3
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2160
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45 SW SEMINOLE ST
Practice Address - Street 2:APT 3
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2160
Practice Address - Country:US
Practice Address - Phone:602-332-1573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Single Specialty