Healthcare Provider Details

I. General information

NPI: 1780311746
Provider Name (Legal Business Name): IMMUNOVIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 CAPITOLA DR STE 11
DURHAM NC
27713-4384
US

IV. Provider business mailing address

801 CAPITOLA DR STE 11
DURHAM NC
27713-4384
US

V. Phone/Fax

Practice location:
  • Phone: 833-593-9522
  • Fax:
Mailing address:
  • Phone: 833-593-9522
  • Fax:

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 CARFORA
Title or Position: VP, MARKET ACCESS & REIMBURSEMENT
Credential:
Phone: 833-593-9522