# VIBRANT DIAGNOSTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vibrant Diagnostics LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962133272
- **Authorized official:** SHIANDRA KEYATA DAVIS (OWNER)
- **Authorized official phone:** (843) 373-8284

## Contact information

- **Practice address:** 514 2ND LOOP RD STE D, FLORENCE, SC 29505-2848
- **Practice address phone:** (843) 373-8284
- **Mailing address:** 108 TIMBERLAKE DR, FLORENCE, SC 29501-9309
- **Mailing address phone:** (843) 373-8284

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/19/2022
- **Last updated:** 06/19/2022