Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Executive Image, Inc

Organization Physiological Laboratory · NPI 1326437989

Executive Image, Inc is a Physiological Laboratory in Winston Salem, North Carolina. Registered with an NPI since 2015.

In the registry since
2015
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

470 W Hanes Mill Rd Ste 107
Winston Salem, NC 27105-9102
Phone: (336) 918-6328
Fax: (800) 840-4241
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physiological Laboratory (primary) Taxonomy 293D00000X

Record details

NPI number1326437989
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diana Goolsby — President/Ceo · (336) 918-6328
NPI enumeratedJanuary 20, 2015
Last updated in NPPESJanuary 20, 2015
Mailing address470 W Hanes Mill Rd, Suite 107, Winston Salem, NC 27105-9102

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