MEDICARE: ALPHA DETECT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1861350118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA DETECT LLC

Provider Business Mailing Address
First Line	:	4021 STIRRUP CREEK DR STE 110
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-9352
Country	:	US
Telephone Number	:	561-389-8017
Fax Number	:

Provider Business Practice Location Address
First Line	:	4021 STIRRUP CREEK DR STE 110&300
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-9352
Country	:	US
Telephone Number	:	561-389-8017
Fax Number	:

Authorized Official
Title or Position	:	SENIOR DIRECTOR, OPERATIONS
Name	:	DANIELLE HOLM
Credential	:	MBA
Telephone Number	:	561-389-8017

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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