Provider Demographics
NPI:1235290651
Name:NC DEPT OF HEALTH AND HUMAN SERVICE
Entity Type:Organization
Organization Name:NC DEPT OF HEALTH AND HUMAN SERVICE
Other - Org Name:NORTH CAROLINA STATE LABORATORY OF PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SHONE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, HCLD(ABB)
Authorized Official - Phone:919-807-8990
Mailing Address - Street 1:MSC 1918
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27699-1918
Mailing Address - Country:US
Mailing Address - Phone:919-733-7834
Mailing Address - Fax:919-733-8695
Practice Address - Street 1:4312 DISTRICT DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5490
Practice Address - Country:US
Practice Address - Phone:919-733-7834
Practice Address - Fax:919-733-8695
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF NC DIVISION OF HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-12
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34D0692393291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory