Provider Demographics
NPI:1093414088
Name:ACCELERATED LABS LLC
Entity Type:Organization
Organization Name:ACCELERATED LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NADEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-940-2652
Mailing Address - Street 1:260 PEACHTREE ST NW STE 2200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-1292
Mailing Address - Country:US
Mailing Address - Phone:770-940-2652
Mailing Address - Fax:678-374-1355
Practice Address - Street 1:260 PEACHTREE ST NW STE 2200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1292
Practice Address - Country:US
Practice Address - Phone:770-940-2652
Practice Address - Fax:678-374-1355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory