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General NPI Number Information
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NPI Number | 1588175194
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Entity Type | Organization
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Legal Business Name | BETA LABS, LLC
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 270 CARPENTER DR STE 600
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City | ATLANTA
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State | GA
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Zip | 30328-4931
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Country | US
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Telephone | 404-381-1563
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Fax |
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Provider Business Mailing Address
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Address Line | 2870 PEACHTREE RD NW # 885
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City | ATLANTA
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State | GA
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Zip | 30305-2918
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LAB MANAGER
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Name | ERIC COLLIER
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Credential |
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Telephone | 404-381-1563
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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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