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General NPI Number Information
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NPI Number | 1568302784
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Entity Type | Organization
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Legal Business Name | NEXTGEN DIAGNOSTIC LAB, LLC
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Dates
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Enumeration Date | 03/30/2026
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 1 N CHARLES ST FL 9
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City | BALTIMORE
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State | MD
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Zip | 21201-3758
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Country | US
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Telephone | 443-781-1216
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Fax |
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Provider Business Mailing Address
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Address Line | 295 LIMESTONE CIR
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City | CONYERS
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State | GA
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Zip | 30013-5244
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Country | US
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Telephone | 443-781-1216
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Fax | 443-781-1216
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Authorized Official
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Title or Position | CEO
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Name | VEGAS LAHAIE
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Credential |
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Telephone | 443-781-1216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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