Organization
GENESIS PROJECT MEDICAL LABORATORY
Active
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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