Healthcare Provider Details

I. General information

NPI: 1295668267
Provider Name (Legal Business Name): GREATER LABORATORY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 NEWTON RD STE 4
ALBANY GA
31701-7405
US

IV. Provider business mailing address

5425 NEWTON RD STE4
ALBANY GA
31701
US

V. Phone/Fax

Practice location:
  • Phone: 229-310-9479
  • Fax: 229-518-2489
Mailing address:
  • Phone: 229-310-9479
  • Fax: 229-518-2489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SHWANA L JAY
Title or Position: OWNER
Credential:
Phone: 229-310-9479