Organization
CAROLINA OUTREACH, LLC
Active
Organization
CAROLINA OUTREACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROB DAVIS (HUMAN RESOURCES)
(919) 251-9001
Entity
Organization
Contact information
Practice address
3012 FALSTAFF RD, RALEIGH, NC 27610-1813
(919) 251-9001
(919) 251-9008
Mailing address
3012 FALSTAFF RD, RALEIGH, NC 27610-1813
(919) 251-9001
(919) 251-9008
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
34D2085492
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34D2085492
CLIA CERTIFICATION
NC
Enumeration date
12/05/2014
Last updated
01/28/2015
Update your record
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