MEDICARE: XPRESS ONE LABS- GEORGIA LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	291U00000X	Clinical Medical Laboratory
3	247000000X	Health Information Technician

General Provider Information

NPI Number	:	1356298186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	XPRESS ONE LABS- GEORGIA LLC

Provider Business Mailing Address
First Line	:	3009 RAINBOW DR STE 303
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30034-1819
Country	:	US
Telephone Number	:	888-243-3926
Fax Number	:	888-243-3926

Provider Business Practice Location Address
First Line	:	3009 RAINBOW DR STE 303
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30034-1819
Country	:	US
Telephone Number	:	888-243-3926
Fax Number	:	888-243-3926

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	MR. GERALD COLEMAN JR.
Credential	:
Telephone Number	:	888-243-3926

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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