Healthcare Provider Details

I. General information

NPI: 1316274764
Provider Name (Legal Business Name): AP LABORATORY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 06/01/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 DORCHESTER MANOR BLVD
NORTH CHARLESTON SC
29420-8108
US

IV. Provider business mailing address

PO BOX 2697
STATESBORO GA
30459-2697
US

V. Phone/Fax

Practice location:
  • Phone: 912-225-9712
  • Fax: 703-991-7215
Mailing address:
  • Phone: 912-225-9712
  • Fax: 703-991-7215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS CARICO
Title or Position: CEO
Credential:
Phone: 843-605-5087