Provider Demographics
NPI:1477301075
Name:ONE STICK LAB DIAGNOSTICS
Entity type:Organization
Organization Name:ONE STICK LAB DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:TIARA
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL ASST/PHLEBO
Authorized Official - Phone:470-485-4691
Mailing Address - Street 1:5132 ATLANTA HWY
Mailing Address - Street 2:SUITE #110-151
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052
Mailing Address - Country:US
Mailing Address - Phone:470-485-4691
Mailing Address - Fax:
Practice Address - Street 1:5132 ATLANTA HWY
Practice Address - Street 2:SUITE #110-151
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052
Practice Address - Country:US
Practice Address - Phone:470-485-4691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory