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General NPI Number Information
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NPI Number | 1417134636
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Entity Type | Organization
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Legal Business Name | L.T. EXAMS, INC
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 804 COMMERCE BLVD STE D
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City | RIVERDALE
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State | GA
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Zip | 30296-7198
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Country | US
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Telephone | 770-996-4724
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Fax | 770-994-1900
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Provider Business Mailing Address
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Address Line | 804 COMMERCE BLVD STE D
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City | RIVERDALE
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State | GA
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Zip | 30296-7198
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Country | US
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Telephone | 770-996-4724
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Fax | 770-994-1900
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Authorized Official
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Title or Position | CFO
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Name | MRS. TAMIKA BLUE
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Credential |
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Telephone | 770-996-4724
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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 | 07-23687
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License Number State | GA
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