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General NPI Number Information
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NPI Number | 1558957936
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Entity Type | Organization
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Legal Business Name | LAB LINQ GEORGIA
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Dates
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Enumeration Date | 12/18/2020
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Last Update Date | 12/18/2020
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Provider Practice Location Address
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Address Line | 1240 HIGHWAY 138 SW
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City | RIVERDALE
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State | GA
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Zip | 30296-1402
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Country | US
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Telephone | 678-744-4288
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 HIGHWAY 138 SW
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City | RIVERDALE
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State | GA
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Zip | 30296-1402
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Country | US
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Telephone | 678-744-4288
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. ZENOBIA DAY
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Credential | MD, MPH
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Telephone | 404-454-8368
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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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