Organization
DIRECT ACCESS LAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULINE S. PARKER RN (CEO)
(704) 315-8277
Entity
Organization
Contact information
Practice address
4822 ALBEMARLE ROAD, SUITE 110, CHARLOTTE, NC 28205-6621
(704) 631-9934
(704) 379-1824
Mailing address
1940 S MINT ST, CHARLOTTE, NC 28203-4629
(704) 315-8277
(704) 379-1824
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
34D2082931
NC
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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