Organization
RESOURCEFUL CLINICAL LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE TYSON (MANAGING MEMBER)
(980) 213-5501
Entity
Organization
Contact information
Practice address
5412 CENTRAL AVE STE A, CHARLOTTE, NC 28212-2706
(704) 503-9961
(704) 563-3356
Mailing address
5412 CENTRAL AVE STE A, CHARLOTTE, NC 28212-2706
(704) 503-9961
(704) 563-3356
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346704723
—
NC
Enumeration date
01/30/2019
Last updated
12/14/2022
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