Provider Demographics
NPI:1023723657
Name:PEACE OF MIND LAB & TESTING SERVICES
Entity type:Organization
Organization Name:PEACE OF MIND LAB & TESTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLEMONTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-202-9693
Mailing Address - Street 1:1408 TOWN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3549
Mailing Address - Country:US
Mailing Address - Phone:336-202-9693
Mailing Address - Fax:
Practice Address - Street 1:2216 W MEADOWVIEW RD STE 268
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3406
Practice Address - Country:US
Practice Address - Phone:336-938-0080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory