Provider Demographics
NPI:1639541295
Name:HIGHLINE LABS, LLC
Entity Type:Organization
Organization Name:HIGHLINE LABS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIENST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-361-2826
Mailing Address - Street 1:5900 NORTHWOODS BUSINESS PARKWAY
Mailing Address - Street 2:SUITE K
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5747
Mailing Address - Country:US
Mailing Address - Phone:704-361-2826
Mailing Address - Fax:866-829-8918
Practice Address - Street 1:5900 NORTHWOODS BUSINESS PARKWAY
Practice Address - Street 2:SUITE K
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-5747
Practice Address - Country:US
Practice Address - Phone:704-361-2826
Practice Address - Fax:866-829-8918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
291U00000X
NC291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory