NPI 1003052416

The Longstreet Clinic, PC

Organisation Clinical Medical Laboratory Gainesville, GA

Practice location

Address: 725 Jesse Jewell Pkwy SE Suite 260, Gainesville, GA 30501-3834
Phone: (770) 535-0079
Fax: (770) 297-6610
Mailing address: PO Box 658, Gainesville, GA 30503-0658

Authorised official

Name: Amelia L. Collins
Title: Ceo
Phone: (770) 718-1122

Registered specialties

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X Licence 069-004 (GA)

Other Clinical Medical Laboratory providers in Georgia →

Registry record

NPI: 1003052416
Entity type: Organization
NPI issued: 7 Jan 2009
Record last updated: 7 Jan 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.