Organization
SELECT TOXICOLOGY LAB STL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEEGAN MORIARTY (OWNER)
(301) 676-6922
Entity
Organization
Contact information
Practice address
1051 BILL BUYCK BLVD, STE A, MANNING, SC 29102-9242
(803) 505-6100
Mailing address
4950 KELLER SPRINGS RD STE 220, ADDISON, TX 75001-6282
(301) 676-6922
(214) 594-5864
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528122678
CLIA
SC
Enumeration date
01/09/2015
Last updated
03/25/2026
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