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General NPI Number Information
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NPI Number | 1174271423
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Entity Type | Organization
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Legal Business Name | CANAAN MEDICAL LABORATORIES LLC
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 3939 DUNN RD
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City | EASTOVER
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State | NC
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Zip | 28312-8533
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Country | US
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Telephone | 910-479-0325
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Fax |
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Provider Business Mailing Address
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Address Line | 3939 DUNN RD
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City | EASTOVER
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State | NC
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Zip | 28312-8533
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Country | US
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Telephone | 910-479-0325
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Fax |
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Authorized Official
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Title or Position | LAB DIRECTOR/OWNER
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Name | MRS. AQUEBA ROBINSON
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Credential |
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Telephone | 910-479-0325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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