Provider Demographics
NPI:1548517758
Name:DRUG TESTING SERVICE CENTER
Entity type:Organization
Organization Name:DRUG TESTING SERVICE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-430-2676
Mailing Address - Street 1:PO BOX 870115
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-0003
Mailing Address - Country:US
Mailing Address - Phone:770-985-1888
Mailing Address - Fax:866-799-3188
Practice Address - Street 1:10011 PINES BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6189
Practice Address - Country:US
Practice Address - Phone:954-430-2676
Practice Address - Fax:954-430-2891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20090494293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory