Provider Demographics
NPI:1942841127
Name:BONDS LABORATORY & DIAGNOSTIC SERVICES, LLC
Entity Type:Organization
Organization Name:BONDS LABORATORY & DIAGNOSTIC SERVICES, LLC
Other - Org Name:BONDS LDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:A
Authorized Official - Last Name:IFARINDE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:678-831-0706
Mailing Address - Street 1:PO BOX 4950
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30023-4950
Mailing Address - Country:US
Mailing Address - Phone:678-736-6000
Mailing Address - Fax:678-736-6004
Practice Address - Street 1:9280 HIGHWAY 5 STE B
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-1501
Practice Address - Country:US
Practice Address - Phone:678-736-6000
Practice Address - Fax:678-736-6004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2021-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory