Millennium Laboratory Corporation

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

34D1090483 Issued in NC

Legal business name

MILLENNIUM LABORATORY CORPORATION

Practice address

3362 Six Forks Rd
Raleigh, NC 27609-7233

Phone

(919) 785-2933

NPI assigned

Oct 28, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kyle D Stephens

Title

Chief Operations Officer

Phone

(704) 578-5372

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1265685705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 TWIN LAKES PKWY STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282696602",
            "telephone_number": "704-578-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3362 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097233",
            "telephone_number": "919-785-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM LABORATORY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "704-578-5372",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": "34D1090483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.