NPIMap

Organization Active NPI

Presbyterian Laboratory Services

  • Clinical Medical Laboratory
  • Charlotte, NC
National Provider Identifier
1568413441
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PRESBYTERIAN LABORATORY SERVICES
Practice address
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone
(704) 384-4293
NPI assigned
May 15, 2006
Last updated
Oct 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Authorized official

Name
Fred M Hargett
Title
Evp/Cfo
Phone
(704) 384-5184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204-2515

Mailing address

2085 Frontis Plaza Blvd
Winston-Salem, NC 27103-5614
Phone (336) 277-7226

Other identifiers 1

IdentifierTypeStateIssuer
3400053MedicaidNC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0655340Novant Health Presbyterian Medical Center200 Hawthorne Lane, Charlotte, NC 28204AccreditationMar 14, 2027
34D0665289Novant Health Presbyterian Medical Center200 Hawthorne Lane, Charlotte, NC 28204AccreditationFeb 8, 2027
34D2278913Novant Health Presbyterian Medical Center200 Hawthorne Lane, Charlotte, NC 28204Provider-performed microscopyMar 26, 2027
34D2325164Novant Health Presbyterian Medical Center-Nursing200 Hawthorne Lane, Charlotte, NC 28204Certificate of waiverJun 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Prof Staff51 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1568413441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BLVD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271035614",
            "telephone_number": "336-277-7226",
            "fax_number": "336-277-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN LABORATORY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "HARGETT",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "704-384-5184"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400053",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.