Organization
THRIVEPOINT MEDICAL LABORATORIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN DOUGLAS (DIRECTOR)
(866) 704-5227
Entity
Organization
Contact information
Practice address
220 WESTINGHOUSE BLVD STE 405, CHARLOTTE, NC 28273-4260
(833) 704-5227
(704) 943-3046
Mailing address
PO BOX 39494, CHARLOTTE, NC 28278-1026
(704) 200-6395
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891261616
—
NC
01
—
34D2155517
CLIA
NC
Enumeration date
10/18/2018
Last updated
07/01/2021
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