Organization
PATHOLOGISTS DIAGNOSTIC LABORATORY PA
Active
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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