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General NPI Number Information
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NPI Number | 1619239738
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Entity Type | Organization
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Legal Business Name | LAB TEST UNLIMITED, INC
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Dates
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Enumeration Date | 06/14/2012
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 125 W TAYLOR ST
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City | GRIFFIN
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State | GA
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Zip | 30223-3046
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Country | US
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Telephone | 770-412-0077
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Fax | 770-412-1366
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Provider Business Mailing Address
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Address Line | 125 W TAYLOR ST
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City | GRIFFIN
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State | GA
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Zip | 30223-3046
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Country | US
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Telephone | 770-412-0077
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Fax | 770-412-1366
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Authorized Official
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Title or Position | PRESIDENT
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Name | GWEN WARSHAW
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Credential |
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Telephone | 770-412-0077
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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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