{
"Npi": {
"NPI": "1982041521",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "ACCURATE MEDICAL LAB",
"ParentOrgTIN": null,
"OrgName": "ACCURATE MEDICAL LAB INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "140 PARKER RD W",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "DANVILLE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24540-7425",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "336-833-3367",
"MailingAddressFaxNumber": "434-688-0517",
"FirstLinePracticeLocationAddress": "2023 16TH ST",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "GREENSBORO",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27405-5119",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "336-833-3367",
"PracticeLocationAddressFaxNumber": "434-688-0517",
"EnumerationDate": "05/22/2013",
"LastUpdateDate": "01/27/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ELFAYAR",
"AuthorizedOfficialFirstName": "SAID",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "VMD, MBA",
"AuthorizedOfficialTelephoneNumber": "336-833-3367",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": "34D2057342",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}