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General NPI Number Information
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NPI Number | 1851768097
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Entity Type | Organization
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Legal Business Name | LAB SERVICES OF GEORGIA, LLC
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 270 CARPENTER DR STE 602
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City | ATLANTA
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State | GA
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Zip | 30328-4931
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Country | US
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Telephone | 404-381-6594
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Fax |
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Provider Business Mailing Address
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Address Line | 270 CARPENTER DR STE 602
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City | ATLANTA
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State | GA
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Zip | 30328-4931
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Country | US
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Telephone | 404-381-6594
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FERN JOHNSON
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Credential |
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Telephone | 678-852-5272
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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 | 11D2099839
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License Number State | GA
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