# PATHOLOGIC DIAGNOSTIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962371450
- **Authorized official:** PRISCILLA JONES (CREDENTIALING MANAGER)
- **Authorized official phone:** (912) 925-0067

## Contact information

- **Practice address:** 1261 RIBAUT ROAD, BEAUFORT, SC 29902
- **Practice address phone:** (843) 783-2273
- **Mailing address:** 219 W BRYAN ST STE 200, SAVANNAH, GA 31401-2542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZD0900X | Dermatopathology (Pathology) Physician | — | NULL | Yes |
| 207ZD0900X | Dermatopathology (Pathology) Physician | — | — | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | — |
| 246QL0900X | Laboratory Management Specialist/Technologist | — | — | Yes |

## Other

- **Enumeration date:** 11/03/2025
- **Last updated:** 09/08/2026