Healthcare Provider Details

I. General information

NPI: 1356298186
Provider Name (Legal Business Name): XPRESS ONE LABS- GEORGIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 RAINBOW DR STE 303
DECATUR GA
30034-1819
US

IV. Provider business mailing address

3009 RAINBOW DR STE 303
DECATUR GA
30034-1819
US

V. Phone/Fax

Practice location:
  • Phone: 888-243-3926
  • Fax: 888-243-3926
Mailing address:
  • Phone: 888-243-3926
  • Fax: 888-243-3926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. GERALD COLEMAN JR.
Title or Position: MANAGING PARTNER
Credential:
Phone: 888-243-3926