Individual
MRS. CONNIE OLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9005 TWO NOTCH RD, SUITE4, COLUMBIA, SC 29223-5850
(803) 796-8397
(803) 796-8397
Mailing address
15 BROOKMIST, COLUMBIA, SC 29229-9098
(803) 873-0797
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLIA #42D2111606
SC
Other
Enumeration date
04/29/2016
Last updated
04/29/2016
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