Organization
DOMINION DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY ELLIS (PAYER RELATIONS REP)
(802) 734-6392
Entity
Organization
Contact information
Practice address
1191 S BROWNELL RD, SUITE 30, WILLISTON, VT 05495-7415
(802) 651-4060
(802) 651-0736
Mailing address
211 CIRCUIT DR, NORTH KINGSTOWN, RI 02852-7440
(877) 734-9600
(401) 667-0330
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
LCI 00343
RI
Other
Enumeration date
06/25/2009
Last updated
12/14/2022
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