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General NPI Number Information
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NPI Number | 1730098195
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Entity Type | Organization
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Legal Business Name | STAT LAB SOLUTIONS
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Dates
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Enumeration Date | 09/02/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 159 WINDING WAY APT D
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City | LEESBURG
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State | GA
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Zip | 31763-5097
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Country | US
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Telephone | 470-319-9540
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Fax |
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Provider Business Mailing Address
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Address Line | 179 CEDRTIC STR
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City | LEESBURG
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State | GA
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Zip | 31763
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Country | US
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Telephone | 470-319-9540
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Fax | 470-319-9540
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | NICHELLE MILLER
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Credential | MLS
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Telephone | 470-319-9540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246QL0900X
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Taxonomy Name | Laboratory Management Specialist/Technologist
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License Number |
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License Number State |
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