4 Life Lab

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

4 LIFE LAB

Practice address

11709 Fruehauf Dr Ste 103
Charlotte, NC 28273-7285

Phone

(318) 278-1319

NPI assigned

Nov 13, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Markuetric D Stringfellow

Title

Owner

Phone

(318) 278-1319

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1821501800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W OLIVE AVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712706356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11709 FRUEHAUF DR STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282737285",
            "telephone_number": "318-278-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4 LIFE LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "STRINGFELLOW",
        "authorized_official_first_name": "MARKUETRIC",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-278-1319",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.