Healthcare Provider Details

I. General information

NPI: 1427041888
Provider Name (Legal Business Name): METAMETRIX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3425 CORPORATE WAY
DULUTH GA
30096
US

IV. Provider business mailing address

3425 CORPORATE WAY
DULUTH GA
30096
US

V. Phone/Fax

Practice location:
  • Phone: 770-446-5483
  • Fax: 770-441-2237
Mailing address:
  • Phone: 770-446-5483
  • Fax: 770-441-2237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number067007
License Number StateGA

VIII. Authorized Official

Name: MRS. CAROLYN K BRALLEY
Title or Position: PRESIDENT
Credential:
Phone: 770-446-5483