Provider Demographics
NPI:1447205349
Name:ACCESS ANALYTICAL LABORATORY, LLC
Entity Type:Organization
Organization Name:ACCESS ANALYTICAL LABORATORY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-379-4100
Mailing Address - Street 1:5239 W FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5413
Mailing Address - Country:US
Mailing Address - Phone:678-379-4100
Mailing Address - Fax:404-348-0221
Practice Address - Street 1:5239 W FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-5413
Practice Address - Country:US
Practice Address - Phone:678-379-4100
Practice Address - Fax:404-348-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-172291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory