Organization
WAKE DIAGNOSTICS INC
Active
Other names
Wake Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
GOVERDHAN REDDY VAVILALA PHD (CEO)
(919) 462-1494
Entity
Organization
Contact information
Practice address
5129 NC 55, STE 103, DURHAM, NC 27713
(919) 399-1215
(919) 981-9180
Mailing address
5129 NC 55, STE 103, DURHAM, NC 27713
(919) 399-1215
(919) 981-9180
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
34D2150941
NC
Other
Enumeration date
06/12/2018
Last updated
09/12/2025
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