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General NPI Number Information
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NPI Number | 1376462358
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Entity Type | Organization
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Legal Business Name | FRONTIER LAB LLC
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 127 W HARGETT ST STE 301
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City | RALEIGH
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State | NC
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Zip | 27601-1351
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Country | US
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Telephone | 346-396-1252
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Fax |
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Provider Business Mailing Address
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Address Line | 3510 WESLEY POINT DR
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City | BROWNS SUMMIT
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State | NC
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Zip | 27214-9892
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Country | US
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Telephone | 346-396-1252
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JALEN CONRAD MARTIN
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Credential |
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Telephone | 346-396-1252
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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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