Organization
CONCIERGE MEDICAL LAB
Active
Parent organization
CONCIERGE MEDICAL GROUP LLC
Other names
Concierge Medical Lab
Organization subpart
Yes
Provider details
NPI number
Legal business name
CONCIERGE MEDICAL GROUP LLC
Authorized official
SARAH DOCTOR-GREENWADE (CHIEF EXECUTIVE OFFICER)
(803) 722-4988
Entity
Organization
Contact information
Practice address
110 WILDEWOOD PARK DR STE A, COLUMBIA, SC 29223-4301
(803) 722-9888
(803) 656-8135
Mailing address
PO BOX 23328, COLUMBIA, SC 29224-3328
(803) 722-4988
(803) 656-8135
Taxonomy
Speciality
Code
Description
License number
State
207RI0001X
Clinical & Laboratory Immunology (Internal Medicine) Physician
—
—
246RM2200X
Medical Laboratory Technician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
05/28/2024
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