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General NPI Number Information
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NPI Number | 1225547276
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Entity Type | Organization
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Legal Business Name | ADAM SCIENTIFIC LABS
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 09/21/2017
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Provider Practice Location Address
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Address Line | 2225 CENTENNIAL DR STE 103
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City | GAINESVILLE
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State | GA
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Zip | 30504-5760
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Country | US
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Telephone | 404-431-0482
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Fax | 678-702-5819
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Provider Business Mailing Address
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Address Line | 101 MARIETTA ST NW STE 1450
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City | ATLANTA
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State | GA
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Zip | 30303-2759
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Country | US
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Telephone | 404-431-0482
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Fax | 678-707-5819
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Authorized Official
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Title or Position | PRESIDENT
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Name | CECIL BENNETT
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Credential |
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Telephone | 404-431-0482
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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 | 069-023
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License Number State | GA
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