Organization
FOUNDATIONS DIAGNOSTIC LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALLACE L ALSTON (MANAGING MEMBER)
(704) 264-7793
Entity
Organization
Contact information
Practice address
1139 N CHARLOTTE AVE STE C, MONROE, NC 28110-2512
(980) 210-3151
(919) 276-8381
Mailing address
1139 N CHARLOTTE AVE STE C, MONROE, NC 28110-2512
(980) 210-3151
(919) 276-8381
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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