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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

NPI Number 1003883877
LBN Legal business name PATHOLOGISTS DIAGNOSTIC LABORATORY PA
Authorized official CULLEN TAYLOR - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/01/2006
Last updated 12/12/2025 - About 6 months ago
Identifiers
NC License # 22288
NC Medicaid 7001277
VA Medicaid 010345456
NC Other 014HE BCBS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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