MEDICARE: TRUCORE LABORATORIES, LLC

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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1730708215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUCORE LABORATORIES, LLC

Provider Business Mailing Address
First Line	:	920 BLAIRHILL RD # B114
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-1565
Country	:	US
Telephone Number	:	704-970-1803
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 BLAIRHILL RD STE B114
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-1565
Country	:	US
Telephone Number	:	704-970-1803
Fax Number	:	800-506-0738

Authorized Official
Title or Position	:	CEO
Name	:	ENRICO FOXX
Credential	:
Telephone Number	:	704-819-9381

Provider Enumeration Date	:	04/14/2020
Last Update Date	:	12/14/2023

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