Organization
GENESIS PROJECT MEDICAL LABORATORY
Active
Parent organization
GENESIS PROJECT 1, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS PROJECT 1, INC
Authorized official
DR. TRASHA J BLACK PHD (EXECUTIVE DIRECTOR)
(704) 596-0505
Entity
Organization
Contact information
Practice address
1000 ANDERSON ST STE A, CHARLOTTE, NC 28205-1216
(704) 596-0505
Mailing address
5104 REAGAN DR STE 5, CHARLOTTE, NC 28206-1392
(704) 596-0505
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
06/29/2020
Last updated
03/31/2021
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