Healthcare Provider Details

I. General information

NPI: 1265340574
Provider Name (Legal Business Name): NATALIE LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 ELIZABETH AVE STE 8
CHARLOTTE NC
28204-2506
US

IV. Provider business mailing address

1146 BRIDGES ST
SHELBY NC
28152-7204
US

V. Phone/Fax

Practice location:
  • Phone: 980-298-3516
  • Fax: 980-486-1129
Mailing address:
  • Phone: 980-298-3516
  • Fax: 980-486-1129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: NATALIE NICOLE CARELOCK
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential:
Phone: 980-298-3516