Healthcare Provider Details

I. General information

NPI: 1871176123
Provider Name (Legal Business Name): ACCUPATH DIAGNOSTIC LABORATORIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1652 MASON BATES BEND RD
CENTERVILLE TN
37033-3815
US

IV. Provider business mailing address

PO BOX 2240
BURLINGTON NC
27216-2240
US

V. Phone/Fax

Practice location:
  • Phone: 615-490-1362
  • Fax: 615-263-1635
Mailing address:
  • Phone:
  • 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: KIMBERLY T WILLIAMS
Title or Position: VICE PRESIDENT
Credential:
Phone: 800-222-7566