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General NPI Number Information
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NPI Number | 1588353965
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Entity Type | Organization
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Legal Business Name | FAST ACTION LABS LLC
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Dates
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Enumeration Date | 05/02/2023
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 715 VILLAGE SQUARE DR
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-3379
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Country | US
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Telephone | 470-216-5446
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Fax | 678-615-2314
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Provider Business Mailing Address
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Address Line | 715 VILLAGE SQUARE DR
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-3379
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Country | US
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Telephone | 470-216-5446
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Fax | 678-615-2314
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Authorized Official
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Title or Position | OWNER
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Name | AALEEAH BELL-MCCRARY
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Credential |
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Telephone | 678-761-9847
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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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