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Organization

PATHOLOGISTS DIAGNOSTIC LABORATORY PA

Active
Other names
Atlantic Pathology Services PA
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CARLA N SMITH (CLIENT SERVICES MANAGER)
(336) 999-8888
Entity
Organization

Contact information

Practice address
630 BROOKWOOD BUSINESS PARK DR, WINSTON SALEM, NC 27105-4478
(336) 999-8888
(336) 999-8889
Mailing address
PO BOX 30369, WINSTON SALEM, NC 27130-0369
(369) 998-8883
(369) 998-8889

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010345456
VA
05
7001277
NC
05
L00213
SC
Enumeration date
03/16/2012
Last updated
11/24/2020
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