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General NPI Number Information
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NPI Number | 1356009849
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Entity Type | Organization
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Legal Business Name | THE LAB GENIUS INC.
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Dates
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Enumeration Date | 12/02/2021
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 777 CLEVELAND AVE SW STE 516
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City | ATLANTA
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State | GA
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Zip | 30315-7115
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Country | US
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Telephone | 404-245-5543
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Fax | 866-502-0926
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Provider Business Mailing Address
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Address Line | 777 CLEVELAND AVE SW STE 516
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City | ATLANTA
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State | GA
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Zip | 30315-7115
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Country | US
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Telephone | 404-245-5543
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Fax | 866-502-0926
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Authorized Official
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Title or Position | CO-FOUNDER/COO
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Name | DARRYLE MAURICE FARRAR
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Credential |
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Telephone | 404-245-5543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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