Organization
SECURE DIAGNOSTIC LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHANTRIS BASS (CEO/OWNER)
(336) 403-3239
Entity
Organization
Contact information
Practice address
1540 WESTBROOK PLAZA DR STE B, WINSTON SALEM, NC 27103-1331
(743) 900-3306
Mailing address
1039 GLENMONT RD, WINSTON SALEM, NC 27107-1561
(336) 403-3239
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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