7 items, in order: articles of organization (llc) and the annual report, assumed business name certificate (dba), employer identification number (ein), business registration for sales and use tax and withholding (nc-br), zoning approval, certificate of occupancy and local business registration and physician ownership and oversight, and 1 more.
How to open, North Carolina
How to open a med spa in North Carolina
7 licenses, permits and registrations, in the order to get them, each with the agency, the fee and the official page.
7 licenses, permits and registrations, in the order to get them
Every row checked against its agency’s page; the latest on Oct 17, 2026.
Set up the business
Articles of organization (LLC) and the annual report
File online. The articles need a North Carolina registered agent with a street address. Missing the annual report leads to a notice and then administrative dissolution.
Checked Oct 17, 2026
- Agency
- North Carolina Secretary of State, Business Registration Division
- Official page
- Members
- Fee
- Members
- Renewal
- Members
Assumed business name certificate (DBA)
Needed when the business trades under any name other than the owner’s or the entity’s exact registered name. One certificate can cover up to five assumed names and every county where the business operates; the Secretary of State keeps the statewide index.
Checked Oct 17, 2026
- Agency
- Register of Deeds in the county where the business mainly operates
- Official page
- Members
- Fee
- Members
- Renewal
- Members
Employer Identification Number (EIN)
Needed to hire, to open a business bank account and for the Department of Revenue registration. Issued at once online.
Checked Oct 17, 2026
- Agency
- Internal Revenue Service
- Official page
- Members
- Fee
- Members
- Renewal
- Members
Register for tax
Business registration for sales and use tax and withholding (NC-BR)
Register online before the first sale; the certificate of registration arrives by mail within about 10 business days, so allow for that before opening. Add income tax withholding in the same application once you have employees. Prepared food carries the county’s extra meals tax in several counties.
Checked Oct 17, 2026
- Agency
- North Carolina Department of Revenue
- Official page
- Members
- Fee
- Members
- Renewal
- Members
Approve the space
Zoning approval, certificate of occupancy and local business registration
Confirm the zoning allows your use before signing the lease, pull building and sign permits for the build-out, and get the certificate of occupancy before the health inspection or opening. Business personal property is listed with the county tax office each January.
Checked Oct 17, 2026
- Agency
- Your city or county planning, inspections and tax offices
- Official page
- Members
- Fee
- Members
- Renewal
- Members
Get the permits for your kind of business
Physician ownership and oversight
The Board treats lasers, injectables and other treatments that alter living tissue as the practice of medicine, so the entity must be owned by a physician or an allowed combination of licensed professionals, with a physician responsible for each patient’s evaluation and orders. Nurses may perform delegated procedures under written protocols; estheticians stop at the skin’s surface.
Checked Oct 17, 2026
- Agency
- North Carolina Medical Board
- Official page
- Members
- Fee
- Members
- Renewal
- Members
Before the first hire
Unemployment insurance account, new hire reporting and workers’ compensation
Register in NCSUITS once you have payroll. Report each new hire within 20 days. Workers’ compensation insurance is required once you employ three or more people, counting officers and LLC members.
Checked Oct 17, 2026
- Agency
- North Carolina Division of Employment Security (NCSUITS); NC New Hire Directory; Industrial Commission
- Official page
- Members
- Fee
- Members
- Renewal
- Members
How they fare in North Carolina
- Closed in 2023, health care and social assistance
- 7.5%
- Opened in 2023
- 10.6%
Then pick the place
- The free location checkWho lives and works around an address, the med spas already there and the traffic on its road, from public records.
- The full reportWhether the rules allow a med spa at that address, the rent it supports, what has opened and closed nearby, and the questions to settle before signing.
Have an address in mind?
Check the address freeNo account. The med spa check reads public records at the address itself.
Sources and dates
Secretary of State fee schedule for limited liability companies; G.S. 66-71.4; Durham and Brunswick County Register of Deeds instructions; IRS EIN page; Department of Revenue online business registration (form NC-BR); Secretary of State business licensing guidance; local ordinances; Medical Board position statements on laser procedures and on contact with patients before prescribing; Board of Nursing cosmetic procedure guidance; Division of Employment Security employer pages and 2026 tax rate table; Industrial Commission employer requirements; U.S. Census Bureau Business Dynamics Statistics. Fees are as published by each agency on the date checked; cities add their own.