| NPI | 1003052416 |
|---|---|
| Doing Business As | THE LONGSTREET CLINIC DEPT OF PATHOLOGY/INTERLAB |
| Entity Type | Organization |
| Authorized Contact | AMELIA L. COLLINS CEO 770-718-1122 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: GA 069-004) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |