Provider Demographics
NPI:1275284747
Name:MND DIAGNOSTIC SOLUTIONS LLC
Entity Type:Organization
Organization Name:MND DIAGNOSTIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-753-3973
Mailing Address - Street 1:3196 MOUNT ZION RD APT 1307
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6818
Mailing Address - Country:US
Mailing Address - Phone:470-753-3973
Mailing Address - Fax:
Practice Address - Street 1:3196 MOUNT ZION RD APT 1307
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6818
Practice Address - Country:US
Practice Address - Phone:470-753-3973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-15
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory