MEDICARE: SIMPLICITY HEALTHCARE DIAGNOSTICS & LABS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247ZC0005X	Clinical Laboratory Director (Non-physician)

General Provider Information

NPI Number	:	1548115652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMPLICITY HEALTHCARE DIAGNOSTICS & LABS

Provider Business Mailing Address
First Line	:	6741 CHURCH ST STE 2
Second Line	:
City	:	RIVERDALE
State	:	GA
Zip	:	30274-2249
Country	:	US
Telephone Number	:	770-305-6487
Fax Number	:	770-216-1574

Provider Business Practice Location Address
First Line	:	6741 CHURCH ST STE 2
Second Line	:
City	:	RIVERDALE
State	:	GA
Zip	:	30274-2249
Country	:	US
Telephone Number	:	770-305-6487
Fax Number	:	770-216-1574

Authorized Official
Title or Position	:	DIRECTOR
Name	:	VALERIE RACHEL
Credential	:
Telephone Number	:	770-305-6640

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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