Organization
UHS-DL LP
Active
Other names
Dynacare Tennessee
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RUPEKA (FINANCE DIRECTOR)
(865) 544-9687
Entity
Organization
Contact information
Practice address
1924 ALCOA HWY, # U108, KNOXVILLE, TN 37920-1511
(865) 544-6869
(865) 544-8273
Mailing address
1924 ALCOA HWY, # U108, KNOXVILLE, TN 37920-1511
(865) 544-6869
(865) 544-8273
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000002102
DOH STATE LICENSE
TN
05
—
3403758
—
TN
05
—
37000072
—
KY
05
—
7001197
—
NC
05
—
L00143
—
SC
Enumeration date
06/16/2005
Last updated
08/22/2020
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