PREMIUM LABS LLC NPI 1649977398

NPI Information

  • NPI: 1649977398
  • Provider Name: PREMIUM LABS LLC
  • Classification: Point of Service - 305S00000X
  • Entity Type: Organization
  • CLIA Number: 42D2276553
  • Address: 6729 TWO NOTCH RD STE 130
    COLUMBIA, SC
    ZIP 29223
  • Phone: (803) 398-9500

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NPI Details

PREMIUM LABS LLC is a point of service in Columbia, SC. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. PREMIUM LABS LLC NPI is 1649977398. The provider is registered as an organization entity type.

The provider's business location address is:

6729 TWO NOTCH RD STE 130
COLUMBIA, SC
ZIP 29223-535
Phone: (803) 398-9500

The provider's authorized official is Keyanne Holmes .
The authorized official title is Director Of Opertations and has the following contact phone number (803) 398-9500.

The CLIA number assigned to this NPI record is 42D2276553 - other - diagnostic testing with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/13/2023 and was last updated on 2/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305S00000XPoint of ServiceYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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