Organization
DOMINION DIAGNOSTICS LLC
Active
Organization
DOMINION DIAGNOSTICS LLC
Active
Parent organization
DOMINION DIAGNOSTICS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DOMINION DIAGNOSTICS LLC
Authorized official
MARK A MCSALLY ESQ. (CHIEF OPERATING OFFICER)
(401) 667-0868
Entity
Organization
Contact information
Practice address
706 GREEN VALLEY RD, SUITE 105, GREENSBORO, NC 27408-7038
(877) 734-9600
(401) 667-0330
Mailing address
211 CIRCUIT DR, NORTH KINGSTOWN, RI 02852-7440
(877) 734-9600
(401) 667-0330
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34D2089118
CLIA REGISTRATION
NC
Enumeration date
01/08/2015
Last updated
01/08/2015
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