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General NPI Number Information
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NPI Number | 1295517068
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Entity Type | Organization
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Legal Business Name | MAKO MEDICAL LABORATORIES, LLC
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 2277 THUNDERSTICK DR
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City | LEXINGTON
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State | KY
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Zip | 40505-9002
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Country | US
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Telephone | 919-351-6256
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Fax | 919-882-9211
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Provider Business Mailing Address
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Address Line | 4901 GLENWOOD AVE STE 300
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City | RALEIGH
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State | NC
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Zip | 27612-3820
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Country | US
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Telephone | 919-351-6256
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Fax | 919-351-6256
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Authorized Official
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Title or Position | COO
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Name | JOSHUA RYAN ARANT
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Credential |
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Telephone | 704-517-4245
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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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