Provider Demographics
NPI:1124787064
Name:SKAI LAB LLC
Entity type:Organization
Organization Name:SKAI LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-870-1249
Mailing Address - Street 1:5902 LAUREL CREEK CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-8259
Mailing Address - Country:US
Mailing Address - Phone:704-870-1249
Mailing Address - Fax:
Practice Address - Street 1:5902 LAUREL CREEK CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-8259
Practice Address - Country:US
Practice Address - Phone:704-870-1249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory