Healthcare Provider Details

I. General information

NPI: 1952123473
Provider Name (Legal Business Name): KESS MAJ LABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 11/09/2024
Certification Date: 11/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2832 RANDLEMAN RD STE H-3
GREENSBORO NC
27406-5193
US

IV. Provider business mailing address

2832 RANDLEMAN RD STE H-3
GREENSBORO NC
27406-5193
US

V. Phone/Fax

Practice location:
  • Phone: 336-929-8134
  • Fax: 877-552-1628
Mailing address:
  • Phone: 336-929-8134
  • Fax: 877-552-1628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MRS. NATASHA LATOYA TORRES
Title or Position: OWNER/OPERATOR/LAB DIRECTOR
Credential:
Phone: 336-929-8134