Provider Demographics
NPI:1891135299
Name:K&S CLINICAL DIAGNOSTICS CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:K&S CLINICAL DIAGNOSTICS CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MED OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAGED
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:BS, PHD, MD
Authorized Official - Phone:678-584-3755
Mailing Address - Street 1:1995 N PARK PL SE STE 205
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2023
Mailing Address - Country:US
Mailing Address - Phone:404-975-0262
Mailing Address - Fax:404-975-0164
Practice Address - Street 1:1995 N PARK PL SE STE 205
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339
Practice Address - Country:US
Practice Address - Phone:678-608-2468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA291U00000X
GA11D2053177291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory