Substance Abuse Treatment Labs, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

326822 Issued in NC

Legal business name

SUBSTANCE ABUSE TREATMENT LABS, LLC

Practice address

1100 Revolution Mill Dr
Suite 1
Greensboro, NC 27405-5067

Phone

(336) 324-0550

NPI assigned

Aug 8, 2014

Last updated

Aug 8, 2014By 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

Mr. Paul Fribush

Title

Owner

Phone

(336) 324-0550

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407456000000",
    "number": "1811306483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REVOLUTION MILL DR",
            "address_2": "SUITE 1",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REVOLUTION MILL DR",
            "address_2": "SUITE 1",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055067",
            "telephone_number": "336-324-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBSTANCE ABUSE TREATMENT LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-08",
        "last_updated": "2014-08-08",
        "status": "A",
        "authorized_official_last_name": "FRIBUSH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-324-0550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": "326822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "326822",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "34D2080227",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zengliu Su, DABCC
• Joseph Jonathan Suarez, P.A.
• Michelle Bennett Suber, MS, RD, LDN
• Tiffany Suber, NURSE PRACTITIONER
• Rachel Emily Suberman
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• Harry Suggs Jr., LCAS
• Asmaa Suleiman

• Clinical Medical Laboratory in Greensboro, NC
• Providers in Greensboro, 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 Aug 8, 2014; 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.