Provider Demographics
NPI:1295696219
Name:MOORMAN DIAGNOSTICS AND COLLECTIONS
Entity type:Organization
Organization Name:MOORMAN DIAGNOSTICS AND COLLECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:INGA
Authorized Official - Middle Name:TYESHA MADRID
Authorized Official - Last Name:PELOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-820-7281
Mailing Address - Street 1:122 GREEN FOREST TRL
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-6140
Mailing Address - Country:US
Mailing Address - Phone:919-820-7281
Mailing Address - Fax:
Practice Address - Street 1:122 GREEN FOREST TRL
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-6140
Practice Address - Country:US
Practice Address - Phone:919-820-7281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory