Provider Demographics
NPI:1316832629
Name:SPECIMEN COMPLIANCE GROUP
Entity type:Organization
Organization Name:SPECIMEN COMPLIANCE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONIECE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-236-5333
Mailing Address - Street 1:1302 WATSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3436
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:627 MILLRUN CT
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210
Practice Address - Country:US
Practice Address - Phone:803-236-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No291U00000XLaboratoriesClinical Medical Laboratory
No293D00000XLaboratoriesPhysiological Laboratory