Organization
PREMIUM LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEYANNE HOLMES (DIRECTOR OF OPERTATIONS)
(803) 398-9500
Entity
Organization
Contact information
Practice address
6729 TWO NOTCH RD STE 130, COLUMBIA, SC 29223-7535
(803) 398-9500
Mailing address
6729 TWO NOTCH RD STE 130, COLUMBIA, SC 29223-7535
(803) 398-9500
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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