Provider Demographics
NPI:1881937373
Name:CORRLABS, LLC
Entity type:Organization
Organization Name:CORRLABS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CORRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-294-0099
Mailing Address - Street 1:340 COMMERCE AVENUE
Mailing Address - Street 2:UNIT 10
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-7115
Mailing Address - Country:US
Mailing Address - Phone:910-294-0099
Mailing Address - Fax:910-637-0004
Practice Address - Street 1:340 COMMERCE AVENUE
Practice Address - Street 2:UNIT 10
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-7115
Practice Address - Country:US
Practice Address - Phone:910-294-0099
Practice Address - Fax:910-637-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC191175291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1881937373Medicaid
SCL00401Medicaid
SCL00401Medicaid
NCD146Medicare PIN