Provider Demographics
NPI:1023776648
Name:BLUE RIDGE LABORATORIES LLC
Entity type:Organization
Organization Name:BLUE RIDGE LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-650-4641
Mailing Address - Street 1:660 MERRIMON AVE STE E
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-3567
Mailing Address - Country:US
Mailing Address - Phone:828-774-5016
Mailing Address - Fax:
Practice Address - Street 1:660 MERRIMON AVE STE E
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-3567
Practice Address - Country:US
Practice Address - Phone:828-774-5016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory