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General NPI Number Information
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NPI Number | 1841110996
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Entity Type | Organization
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Legal Business Name | TRUE TRACE DIAGNOSTIC LABS
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 1135 BRIDGEFIELD PL APT 107
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City | CHARLOTTE
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State | NC
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Zip | 28216-6030
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Country | US
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Telephone | 704-915-8786
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 133
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City | PAW CREEK
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State | NC
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Zip | 28130-0133
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Country | US
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Telephone | 704-915-8786
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | QUANOLIA E SANDERS
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Credential |
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Telephone | 704-915-8786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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