Provider Demographics
NPI:1033687116
Name:PINNACLE LABORATORY SERVICES, LLC
Entity Type:Organization
Organization Name:PINNACLE LABORATORY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAVONDELL
Authorized Official - Middle Name:
Authorized Official - Last Name:STALLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-689-8902
Mailing Address - Street 1:1325 S EUGENE ST STE 204
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-1470
Mailing Address - Country:US
Mailing Address - Phone:336-689-8902
Mailing Address - Fax:336-378-0180
Practice Address - Street 1:1325 S EUGENE ST STE 204
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-1470
Practice Address - Country:US
Practice Address - Phone:336-689-8902
Practice Address - Fax:336-378-0180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory