Healthcare Provider Details

I. General information

NPI: 1952396202
Provider Name (Legal Business Name): GREENSBORO PATHOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 GREEN VALLEY RD SUITE 104
GREENSBORO NC
27408-7038
US

IV. Provider business mailing address

1355 RIVER BEND DR
DALLAS TX
75247-4915
US

V. Phone/Fax

Practice location:
  • Phone: 336-271-4930
  • Fax: 336-271-8466
Mailing address:
  • Phone: 214-638-2000
  • Fax: 844-751-9262

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: DINA VALLADARES
Title or Position: SR. DIRECTOR
Credential:
Phone: 561-514-5822