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Organization

SOUTHEAST MEDICAL LABORATORY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN HODGSON MD (LAB DIRECTOR)
(910) 642-3697
Entity
Organization

Contact information

Practice address
619 JEFFERSON ST, WHITEVILLE, NC 28472-3707
(910) 642-3697
(910) 642-5929
Mailing address
PO BOX 790, WHITEVILLE, NC 28472-0790
(910) 641-0400
(910) 642-5929

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0270C
BCBS OF NC
NC
05
8900473
NC
Enumeration date
09/20/2006
Last updated
07/21/2022
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