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General NPI Number Information
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NPI Number | 1730628439
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Entity Type | Organization
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Legal Business Name | OXY-GEN LABORATORY LLC
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 303 RESEARCH DR STE 300
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30092-7001
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Country | US
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Telephone | 770-686-3620
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Fax | 888-316-1232
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Provider Business Mailing Address
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Address Line | 5680 OAKBROOK PKWY STE 100
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City | NORCROSS
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State | GA
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Zip | 30093-1841
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Country | US
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Telephone | 770-686-3620
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Fax | 888-316-1232
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Authorized Official
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Title or Position | MANAGER
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Name | JEAN FRANCOIS TOURE
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Credential |
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Telephone | 770-771-2925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0007X
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Taxonomy Name | Molecular Genetic Pathology (Pathology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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