Organization
SUBSTANCE ABUSE TREATMENT LABS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL FRIBUSH (OWNER)
(336) 324-0550
Entity
Organization
Contact information
Practice address
1100 REVOLUTION MILL DR, SUITE 1, GREENSBORO, NC 27405-5067
(336) 324-0550
Mailing address
1100 REVOLUTION MILL DR, SUITE 1, GREENSBORO, NC 27405-5067
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
326822
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
326822
LICENSE
NC
01
—
34D2080227
CLIA
NC
Enumeration date
08/08/2014
Last updated
08/08/2014
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