Provider Demographics
NPI:1932997681
Name:1 CORP DIAGNOSTICS
Entity type:Organization
Organization Name:1 CORP DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-500-8026
Mailing Address - Street 1:2806 RANDLEMAN RD STE D
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-5266
Mailing Address - Country:US
Mailing Address - Phone:336-500-8026
Mailing Address - Fax:336-900-0159
Practice Address - Street 1:2806 RANDLEMAN RD STE D
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-5266
Practice Address - Country:US
Practice Address - Phone:336-500-8026
Practice Address - Fax:336-900-0159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory