Provider Demographics
NPI:1720335334
Name:CLIO LABORATORY, LLC
Entity Type:Organization
Organization Name:CLIO LABORATORY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ADMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-247-8098
Mailing Address - Street 1:9300 HARRIS CORNERS PKWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-3790
Mailing Address - Country:US
Mailing Address - Phone:704-247-8098
Mailing Address - Fax:704-285-6480
Practice Address - Street 1:2701 HUTCHISON MCDONALD RD
Practice Address - Street 2:SUITE E
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-4217
Practice Address - Country:US
Practice Address - Phone:704-247-8098
Practice Address - Fax:704-285-6480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34D2043439291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory