Provider Demographics
NPI:1619239738
Name:LAB TEST UNLIMITED, INC
Entity Type:Organization
Organization Name:LAB TEST UNLIMITED, INC
Other - Org Name:GEORGIA ON SITE LAB TESTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-412-0077
Mailing Address - Street 1:125 W TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-3046
Mailing Address - Country:US
Mailing Address - Phone:770-412-0077
Mailing Address - Fax:770-412-1366
Practice Address - Street 1:125 W TAYLOR ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-3046
Practice Address - Country:US
Practice Address - Phone:770-412-0077
Practice Address - Fax:770-412-1366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory