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General NPI Number Information
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NPI Number | 1679566954
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Entity Type | Organization
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Legal Business Name | CLINICAL LABORATORY SERVICES, INC
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 07/20/2007
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Provider Practice Location Address
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Address Line | 102 LINCOLN MEDICAL PARK 102 LINCOLN MEDICAL PARK
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City | LINCOLNTON
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State | NC
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Zip | 28092-4402
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Country | US
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Telephone | 704-732-1752
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Fax | 704-736-0273
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Provider Business Mailing Address
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Address Line | 1446 E GASTON ST 102 LINCOLN MEDICAL PARK
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City | LINCOLNTON
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State | NC
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Zip | 28092-4416
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Country | US
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Telephone | 704-732-1752
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Fax | 704-736-0273
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARGARET ANN HYDER
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Credential |
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Telephone | 704-732-1752
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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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