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Organization

EXPRESS TEST CHARLOTTE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA M WILKINSON (SUPERVISOR)
(317) 710-0354
Entity
Organization

Contact information

Practice address
227 W 4TH ST # 318, CHARLOTTE, NC 28202-1545
(980) 288-4099
Mailing address
525 S CHURCH ST APT 1905, CHARLOTTE, NC 28202-3321
(317) 710-0354

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34D2258491
CLIA
NC
Enumeration date
07/27/2022
Last updated
07/27/2022
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