Provider Demographics
NPI:1184041949
Name:PARADIGM LABS, LLC
Entity Type:Organization
Organization Name:PARADIGM LABS, LLC
Other - Org Name:PARADIGM LABS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-342-2443
Mailing Address - Street 1:1302 FOUNTAIN PARK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4860
Mailing Address - Country:US
Mailing Address - Phone:912-342-2443
Mailing Address - Fax:912-634-5246
Practice Address - Street 1:1302 FOUNTAIN PARK CIRCLE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4860
Practice Address - Country:US
Practice Address - Phone:912-342-2443
Practice Address - Fax:912-634-5246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory