Foundations Diagnostic Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

FOUNDATIONS DIAGNOSTIC LABORATORY LLC

Practice address

1139 N Charlotte Ave Ste C
Monroe, NC 28110-2512

Phone

(980) 210-3151

Fax

(919) 276-8381

NPI assigned

May 2, 2023

Last updated

May 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wallace L AlstonNPI 1023594108

Title

Managing Member

Phone

(704) 264-7793

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wallace Lamone Alston

  • Addiction (Substance Use Disorder) Counselor
  • Charlotte, NC
  • NPI 1023594108
  NPD Authorized official

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1609565027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 N CHARLOTTE AVE STE C",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281102512",
            "telephone_number": "980-210-3151",
            "fax_number": "919-276-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 N CHARLOTTE AVE STE C",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281102512",
            "telephone_number": "980-210-3151",
            "fax_number": "919-276-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATIONS DIAGNOSTIC LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "ALSTON",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "704-264-7793"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam W Fosnaugh, M.D.
• Chelsea Nicole Foster, PT
• Michelle Lynette Foster, MD
• Bethany Fosu, MD
• Foundation Health Mobile Imaging, LLC (Foundation Mobile 1)
• Fox Counseling and Consulting, PLLC
• Bryce Michael Fox, PHARMD
• Carolyn Franks, AUD, CCC-A
• Lynn Little Frederick, RN
• Kaitlyn Free

• Clinical Medical Laboratory in Monroe, NC
• Providers in Monroe, 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 May 2, 2023; 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.