Organization
NOVUS LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERA W COULTER A.S. (DIRECTOR OF LABORATORY OPERATIONS)
(276) 525-4606
Entity
Organization
Contact information
Practice address
14270 LEE HWY, BRISTOL, VA 24202-4316
(276) 525-4606
(276) 525-4608
Mailing address
14270 LEE HWY, BRISTOL, VA 24202-4316
(276) 525-4606
(276) 525-4608
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
49D2042544
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530278
—
TN
05
—
1760743090
—
VA
01
—
4334814
BC/BS
TN
01
—
49D2042544
CLIA
VA
Enumeration date
06/04/2012
Last updated
05/06/2014
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