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General NPI Number Information
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NPI Number | 1831592096
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Entity Type | Organization
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Legal Business Name | SERENITY LABORATORIES LLC
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 1451 NORTHSIDE DR NW STE B
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City | ATLANTA
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State | GA
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Zip | 30318-4201
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Country | US
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Telephone | 404-228-5027
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Fax |
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Provider Business Mailing Address
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Address Line | 1451 NORTHSIDE DR NW
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City | ATLANTA
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State | GA
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Zip | 30318-4201
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Country | US
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Telephone | 404-228-5027
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Fax | 770-299-4886
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Authorized Official
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Title or Position | OWNER
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Name | ISHVAR PATEL
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Credential |
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Telephone | 678-386-2001
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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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