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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