| NPI | 1760579825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH HAGAN Registered Agent 770-307-5820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: GA 007003) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2025-10-09 |