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General NPI Number Information
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NPI Number | 1881938082
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Entity Type | Organization
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Legal Business Name | ALL CLINICAL LABS,LLC
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Dates
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Enumeration Date | 11/12/2012
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Last Update Date | 11/12/2012
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Provider Practice Location Address
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Address Line | 815 PAVILION CT
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City | MCDONOUGH
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State | GA
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Zip | 30253-6666
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Country | US
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Telephone | 770-898-8842
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Fax | 770-898-8085
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Provider Business Mailing Address
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Address Line | 815 PAVILION CT
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City | MCDONOUGH
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State | GA
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Zip | 30253-6666
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Country | US
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Telephone | 770-898-8842
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Fax | 770-898-8085
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. LORRIE E GRIER- THOMPSON
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Credential | DSM
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Telephone | 770-898-8842
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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 | 10113997
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License Number State | GA
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