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Contact Information

PATHOLOGISTS DIAGNOSTIC LABORATORY PA
1800 S HAWTHORNE RD STE 100
WINSTON-SALEM, NC27103-4014
 Phone: 336-999-8888
 Fax: 336-999-8889
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for PATHOLOGISTS DIAGNOSTIC LABORATORY PA · (Female)

NPI # 1003883877
Status Active
Credentials
Entity Individual
Enumeration date 03/01/2006
Last updated 12/12/2025 - About 6 months ago
Sole proprietor 1 Not specified
Identifiers
  • NC License # 22288
  • NC Medicaid 7001277
  • VA Medicaid 010345456
  • NC Other 014HE BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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