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General NPI Number Information
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NPI Number | 1700662913
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Entity Type | Organization
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Legal Business Name | PROMINENT LABS & TESTING, LLC.
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Dates
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Enumeration Date | 09/04/2023
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Last Update Date | 09/04/2023
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Provider Practice Location Address
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Address Line | 3340 PEACHTREE RD NE STE 1828
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City | ATLANTA
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State | GA
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Zip | 30326-1000
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Country | US
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Telephone | 470-747-1310
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Fax | 404-591-5966
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Provider Business Mailing Address
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Address Line | 3340 PEACHTREE RD NE STE 1828
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City | ATLANTA
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State | GA
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Zip | 30326-1000
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Country | US
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Telephone | 470-747-1310
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Fax | 404-591-5966
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Authorized Official
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Title or Position | OWNER / PHLEBOTOMIST
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Name | MRS. CINDE ADAMS
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Credential | NRCPT
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Telephone | 470-747-1310
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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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