Organization
LAB704 LLC
Active
Organization
LAB704 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATASHA G AIKEN (LPN)
(315) 289-6165
Entity
Organization
Contact information
Practice address
110 STOCKTON ST # E4, STATESVILLE, NC 28677-5253
(315) 289-6165
Mailing address
109 CLODFELTER RD, MOORESVILLE, NC 28115-7810
(315) 289-6165
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/21/2022
Last updated
01/21/2022
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