Organization
HARRIS HISTOLOGY RELIEF SERVICES INC
Active
Organization
HARRIS HISTOLOGY RELIEF SERVICES INC
Active
Parent organization
PROVIA DIAGNOSTICS INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIA DIAGNOSTICS INC.
Authorized official
DR. DEAN A TROYER MD (PRESIDENT, CEO)
(252) 830-6866
Entity
Organization
Contact information
Practice address
2025 EASTGATE DR, SUITE F, GREENVILLE, NC 27858-4154
(252) 830-6866
(252) 830-0032
Mailing address
2025 EASTGATE DR, SUITE F, GREENVILLE, NC 27858-4154
(252) 830-6866
(252) 830-0032
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01952
BCBS
NC
01
—
34D0882748
CLIA
NC
01
—
690007364
RAILROAD MEDICARE
NC
05
—
7001138
—
NC
Enumeration date
04/07/2006
Last updated
05/06/2011
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