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1609692128 NPI number — FIELD LABS DIAGNOSTICS

NPI Number: 1609692128
Health Care Provider/Practitioner: FIELD LABS DIAGNOSTICS

Information about “1609692128” NPI (FIELD LABS DIAGNOSTICS) exists in 1609692128 in HTML format HTML  |  1609692128 in plain Text format TXT  |  1609692128 in PDF (Portable Document Format) PDF  |  1609692128 in an XML format XML  formats.

NPI Number : 1609692128 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609692128",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "FIELD LABS DIAGNOSTICS",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "35 SUMMER LEIGH DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "STOCKBRIDGE",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30281-5895",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "404-452-2817",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "804 COMMERCE BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RIVERDALE",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30296-7198",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "404-452-2817",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/30/2024",
    "LastUpdateDate": "11/30/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "PAULK",
    "AuthorizedOfficialFirstName": "APRIL",
    "AuthorizedOfficialMiddleName": "R",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "CPT, CNA",
    "AuthorizedOfficialTelephoneNumber": "404-452-2817",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "293D00000X",
          "TaxonomyName": "Physiological Laboratory",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "291U00000X",
          "TaxonomyName": "Clinical Medical Laboratory",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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