Organization
MILLENNIUM LABORATORY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE D STEPHENS (CHIEF OPERATIONS OFFICER)
(704) 578-5372
Entity
Organization
Contact information
Practice address
3362 SIX FORKS RD, RALEIGH, NC 27609-7233
(919) 785-2933
Mailing address
9800 TWIN LAKES PKWY STE B, CHARLOTTE, NC 28269-6602
(704) 578-5372
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
34D1090483
NC
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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