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General NPI Number Information
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NPI Number | 1942841127
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Entity Type | Organization
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Legal Business Name | BONDS LABORATORY & DIAGNOSTIC SERVICES, LLC
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 08/29/2021
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Provider Practice Location Address
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Address Line | 9280 HIGHWAY 5 STE B
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-1501
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Country | US
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Telephone | 678-736-6000
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Fax | 678-736-6004
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Provider Business Mailing Address
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Address Line | PO BOX 4950
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City | ALPHARETTA
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State | GA
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Zip | 30023-4950
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Country | US
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Telephone | 678-736-6000
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Fax | 678-736-6004
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Authorized Official
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Title or Position | CEO
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Name | DR. ALFRED A IFARINDE
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Credential | PHD
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Telephone | 678-831-0706
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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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