Ethereal Diagnostics & Services LLC
NPI 1629822259 · Health Service Clinic/Center · Valdosta, GA
Ethereal Diagnostics & Services LLC is a Health Service Clinic/Center organization in Valdosta, GA (NPI 1629822259).
Provider details
- NPI number
- 1629822259
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Porsha Robinson, Ceo(877) 586-2971
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-04-11
- Last updated
- 2024-04-11
- Certified
- 2024-04-11
Frequently asked questions
- What is Ethereal Diagnostics & Services LLC's NPI number?
- Ethereal Diagnostics & Services LLC's National Provider Identifier (NPI) is 1629822259, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ethereal Diagnostics & Services LLC?
- Ethereal Diagnostics & Services LLC is classified in the NPPES registry as Health Service Clinic/Center (Ambulatory Health Care Facilities).
- Where is Ethereal Diagnostics & Services LLC located?
- Ethereal Diagnostics & Services LLC's practice location on file with NPPES is 100 N Patterson St Ste a, Valdosta, GA 31601-5570.
- What is Ethereal Diagnostics & Services LLC's phone number?
- The practice phone number listed in the NPPES registry for Ethereal Diagnostics & Services LLC is (877) 586-2971.
- Who is the authorized official for Ethereal Diagnostics & Services LLC?
- The authorized official listed on Ethereal Diagnostics & Services LLC's NPPES record is Porsha Robinson, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ethereal Diagnostics & Services LLC's NPI active?
- Yes — Ethereal Diagnostics & Services LLC's NPI (1629822259) is active in the NPPES registry as of the last update on 2024-04-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.