Organization
ON THE GO MOBILE LAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TWANDA NICOLE PENDERGRASS CPT,CNA (CEO)
(803) 581-1313
Entity
Organization
Contact information
Practice address
1645 J A COCHRAN BYP STE A1, CHESTER, SC 29706-2105
(803) 581-1313
(803) 620-4635
Mailing address
1645 J A COCHRAN BYP STE A1, CHESTER, SC 29706-2105
(803) 581-1313
(803) 620-4635
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
04/30/2024
Last updated
04/30/2024
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