Organization
NEXTWAVE DIAGNOSTIC LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER D. MCKINNEY M.D. (MEDICAL DIRECTOR/ PARTNER)
(910) 202-2400
Entity
Organization
Contact information
Practice address
1915 S 17TH ST, SUITE 100, WILMINGTON, NC 28401-6626
(910) 202-2400
(910) 202-2499
Mailing address
1915 S 17TH ST, SUITE 100, WILMINGTON, NC 28401-6626
(910) 202-2400
(910) 202-2499
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7001244
—
NC
Enumeration date
03/20/2006
Last updated
08/22/2020
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