NPI 1417240490

Georgia Department of Public Health

Organisation Clinical Medical Laboratory Decatur, GA

Practice location

Address: 1749 Clairmont Rd, Decatur, GA 30033-4005
Phone: (404) 327-7900
Fax: (404) 327-7919
Mailing address: 2 Peachtree Street NW 15th Floor, Atlanta, GA 30303-3142

Authorised official

Name: Brenda R. Fitzgerald
Title: Commissioner
Phone: (404) 657-2700

Registered specialties

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X Licence 044-121 (GA)

Other Clinical Medical Laboratory providers in Georgia →

Registry record

NPI: 1417240490
Entity type: Organization
NPI issued: 24 May 2011
Record last updated: 24 May 2011

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.