MEDICARE: PAL MED LABS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1033847876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAL MED LABS, LLC

Provider Business Mailing Address
First Line	:	3235 SATELLITE BLVD
Second Line	:	BLDG 400 STE 300
City	:	DULUTH
State	:	GA
Zip	:	30096-8688
Country	:	US
Telephone Number	:	682-308-7373
Fax Number	:

Provider Business Practice Location Address
First Line	:	3235 SATELLITE BLVD
Second Line	:	BLDG 400 STE 300
City	:	DULUTH
State	:	GA
Zip	:	30096-8688
Country	:	US
Telephone Number	:	682-308-7373
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MINHAJUDDIN MOHAMMED
Credential	:
Telephone Number	:	682-308-7373

Provider Enumeration Date	:	08/10/2022
Last Update Date	:	03/29/2026

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