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General NPI Number Information
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NPI Number | 1922760362
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Entity Type | Organization
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Legal Business Name | GEORGIA SPEEDY TESTING LLC
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 809 CLEVELAND AVE SW STE 4
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City | ATLANTA
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State | GA
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Zip | 30315-7108
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Country | US
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Telephone | 404-800-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 809 CLEVELAND AVE SW
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City | ATLANTA
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State | GA
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Zip | 30315-7108
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Country | US
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Telephone | 404-800-9800
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGET
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Name | MRS. STEPHANIE BACON
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Credential |
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Telephone | 404-800-9800
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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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