MEDICARE: MISS LERACHIA BELL LAB DIRECTOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247ZC0005X	Clinical Laboratory Director (Non-physician)		NC

General Provider Information

NPI Number	:	1083568976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LERACHIA BELL LAB DIRECTOR

Provider Business Mailing Address
First Line	:	704 E MAIN ST STE A
Second Line	:
City	:	PLYMOUTH
State	:	NC
Zip	:	27962-1508
Country	:	US
Telephone Number	:	888-864-6121
Fax Number	:	252-793-3960

Provider Business Practice Location Address
First Line	:	704 E MAIN ST STE A
Second Line	:
City	:	PLYMOUTH
State	:	NC
Zip	:	27962-1508
Country	:	US
Telephone Number	:	888-864-6121
Fax Number	:	252-793-3960

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	03/15/2026

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