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General NPI Number Information
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NPI Number | 1508774589
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Entity Type | Organization
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Legal Business Name | MG LAB SERVICES LLC.
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 480 GROVE PARK DR # 30248
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City | LOCUST GROVE
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State | GA
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Zip | 30248-4573
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Country | US
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Telephone | 404-834-9934
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Fax |
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Provider Business Mailing Address
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Address Line | 480 GROVE PARK DR
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City | LOCUST GROVE
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State | GA
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Zip | 30248-4573
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Country | US
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Telephone | 404-834-9934
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARJORIEI PETIT
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Credential | OWNERSHIP
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Telephone | 404-834-9934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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