Organization
SOUTHERN DIAGNOSTIC LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE BOYD (CEO)
(205) 313-1240
Entity
Organization
Contact information
Practice address
1050 RIVER OAKS DRIVE, SUITE 120, FLOWOOD, MS 39292
(601) 933-8600
Mailing address
2732 7TH AVE S, BIRMINGHAM, AL 35233-3406
(205) 313-1240
(205) 313-1250
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
25D2003695
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07921751
—
MS
Enumeration date
05/25/2010
Last updated
10/09/2013
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