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STATESBORO IMAGING CENTER P.C. NPI 1811217920


NPI Information

NPI: 1811217920
Provider Name: STATESBORO IMAGING CENTER, P.C.

Doing Business As: STATESBORO IMAGING CENTER

Classification: Physiological Laboratory - 293D00000X
Entity Type: Organization

CLIA Number: 11D2009817

Address:
8 LESTER RD
STATESBORO, GA
ZIP 30458
Phone: (912) 764-5656
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STATESBORO IMAGING CENTER, P.C. is a physiological laboratory in Statesboro, GA. The provider is a laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. STATESBORO IMAGING CENTER, P.C. NPI is 1811217920. The provider is registered as an organization entity type.
The provider Is Doing Business As Statesboro Imaging Center.

The provider's business location address is:

8 LESTER RD
STATESBORO, GA
ZIP 30458-786
Phone: (912) 764-5656
Fax: (912) 764-5659

The provider's authorized official is Don R Connell .
The authorized official title is President and has the following contact phone number (912) 764-5656.

The CLIA number assigned to this NPI record is 11D2009817 - other - idtf (in process) with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/11/2010 and was last updated on 6/11/2010.


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
1293D00000XPhysiological LaboratoryGEORGIAYes

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: 5/5/2024

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