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General NPI Number Information
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NPI Number | 1710804851
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Entity Type | Organization
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Legal Business Name | TRUE DNA DIAGNOSTIC, LLC
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 3461 ROCKMILL DR STE 440
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City | ELLENWOOD
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State | GA
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Zip | 30294-6313
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Country | US
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Telephone | 903-722-3123
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Fax | 903-722-3123
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Provider Business Mailing Address
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Address Line | 909 EAGLES LANDING PKWY STE 440
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-6398
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Country | US
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Telephone | 903-722-3123
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MAKESHA MCCLENTON
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Credential | RN
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Telephone | 903-722-3123
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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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