Organization
RAPHA LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERMAINE BROOKS (PRESIDENT)
(912) 596-7683
Entity
Organization
Contact information
Practice address
839 MAJESTIC CT STE 3, GASTONIA, NC 28054-5152
(980) 395-0239
Mailing address
839 MAJESTIC CT STE 3, GASTONIA, NC 28054-5152
(980) 395-0239
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760192322
—
NC
Enumeration date
12/05/2022
Last updated
06/30/2023
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