Organization
NATIONAL INSTITUTE OF TOXICOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA LINDSEY COX (OFFICE ADMINISTRATOR)
(336) 648-8550
Entity
Organization
Contact information
Practice address
956 N MAIN ST, MOUNT AIRY, NC 27030-3747
(336) 648-8550
(336) 648-8551
Mailing address
956 N MAIN ST, MOUNT AIRY, NC 27030-3747
(336) 648-8550
(336) 648-8551
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
36016
NC
291U00000X
Clinical Medical Laboratory
36016
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01953
—
NC
01
—
205233
NORTH CAROLINA MEDICAL BOARD
NC
01
—
34D2085270
CLIA
NC
01
—
34D22080208
CLIA CERTIFICATE
NC
01
—
70121
BLUE CROSS BLUE SHIELD
NC
Enumeration date
11/01/2014
Last updated
06/21/2023
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