Organization · NPI-2
1 Stikk Mobile Richmond
Clinical Medical Laboratory · Petersburg, VA
NPI number1821781063
StatusActive
Last updated in NPPESDec 22, 2024
Details
- NPI
- 1821781063
- Entity type
- Organization (NPI-2)
- Legal business name
- 1 Stikk Mobile Richmond
- Organization subpart
- No
- Enumeration date
- Jun 1, 2023
- Certification date
- Dec 22, 2024
- Last updated
- Dec 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 291U00000X | Clinical Medical Laboratory | – | – | Yes |
| 261QH0100X | Clinic/Center, Health Services | – | – | |
| 261QU0200X | Clinic/Center, Urgent Care | – | – |
Other names
- 1 Stikk Moblie Laboratory LLC (Other Name)
Practice location
1121 Stainback StApt 3201
Petersburg, VA 23803-3969
Phone 318-512-0170
Mailing address
1121 Stainback StApt 3201
Petersburg, VA 23803-3969
Phone 318-512-0170
Other practice locations
303 Timberland Dr Ne
Ludowici, GA 31316-6669
Ludowici, GA 31316-6669
Phone 318-512-0170
Authorized official
Tiffany Clinton
Ownerr
3185120170
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