Organization
ENVISION LAB SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHANTI J GIBSON (OWNER)
(843) 244-0896
Entity
Organization
Contact information
Practice address
136 JANE HARVIN RD, LANE, SC 29564-5010
(843) 244-0896
Mailing address
136 JANE HARVIN RD, LANE, SC 29564-5010
(843) 244-0896
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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