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General NPI Number Information
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NPI Number | 1124890934
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Entity Type | Organization
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Legal Business Name | OMEGA MOLECULAR LABORATORIES LLC
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 6445 SHILOH RD STE B
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City | ALPHARETTA
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State | GA
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Zip | 30005-8407
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Country | US
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Telephone | 470-863-6020
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Fax | 470-200-2285
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Provider Business Mailing Address
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Address Line | 6445 SHILOH RD STE B
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City | ALPHARETTA
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State | GA
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Zip | 30005-8407
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Country | US
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Telephone | 470-863-6020
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Fax | 470-200-2285
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Authorized Official
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Title or Position | CEO
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Name | RODRICK FRAZIER
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Credential |
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Telephone | 310-686-2134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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