Organization · Type 2 NPI

Concierge Medical Lab

Primary Care Clinic/Center · Columbia, SC

NPI number 1366220758 Active

Practice location

110 Wildewood Park Dr Ste A
Columbia, SC 29223-4301

Call (803) 722-9888 Map

Fax (803) 656-8135

Mailing address

PO Box 23328
Columbia, SC 29224-3328

Specialties and licenses

Taxonomy	Code	License
Clinical & Laboratory Immunology (Internal Medicine) Physician	207RI0001X	None listed
Medical Laboratory Technician	246RM2200X	None listed
Primary Care Clinic/Center Primary	261QP2300X	None listed

Primary Care Clinic/Center: Definition to come...

2 other providers at this address

Concierge Medical Group LLCPrimary Care Clinic/Center Columbia, SC NPI 1811407521
Oliver Pierre Harden, MDHospitalist Physician Columbia, SC NPI 1164479747

Other primary care clinic/center providers in Columbia

See all in Columbia →

NPI record

NPI: 1366220758
Entity type: Organization (Type 2)
Issued: Sep 18, 2023
Last updated: May 28, 2024
Status: Active
Subpart: Yes of Concierge Medical Group LLC

Other names

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Concierge Medical Lab · doing business as
Concierge Medical Lab · doing business as

Authorized official

Sarah Doctor-Greenwade
Chief Executive Officer
(803) 722-4988

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1366220758

Concierge Medical Lab's National Provider Identifier is 1366220758, issued on Sep 18, 2023. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Columbia, SC. The record was last updated on May 28, 2024.