Healthcare Provider Details

I. General information

NPI: 1174077580
Provider Name (Legal Business Name): DLS RESEARCH & VENTURES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2016
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 HONEY CREEK CMNS SE STE A
CONYERS GA
30013-5842
US

IV. Provider business mailing address

1700 HONEY CREEK CMNS SE STE A
CONYERS GA
30013-5842
US

V. Phone/Fax

Practice location:
  • Phone: 770-648-8951
  • Fax:
Mailing address:
  • Phone: 770-648-8951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number291U0000X
License Number StateGA

VIII. Authorized Official

Name: DR. DAVID LEE SCOTT JR.
Title or Position: CEO/LAB DIRECTOR
Credential: PHD
Phone: 770-648-8951