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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