Healthcare Provider Details

I. General information

NPI: 1912863713
Provider Name (Legal Business Name): MF EXPRESS LAB AND VITALITY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/25/2025
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 OAK GROVE ST UNIT 8
MOUNT HOLLY NC
28120-1655
US

IV. Provider business mailing address

905 CASSIDY DR
GASTONIA NC
28054-4306
US

V. Phone/Fax

Practice location:
  • Phone: 980-925-5566
  • Fax: 888-830-7437
Mailing address:
  • Phone: 980-925-5566
  • Fax: 888-830-7437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MARLENE CHISHOLM
Title or Position: OWNER
Credential: RN
Phone: 980-437-4109