Provider Demographics
NPI:1720349962
Name:ALLERGY LABS OF AMERICA
Entity Type:Organization
Organization Name:ALLERGY LABS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:MR
Authorized Official - First Name:OFFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-625-4426
Mailing Address - Street 1:3316 S COBB DR SE STE A
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4107
Mailing Address - Country:US
Mailing Address - Phone:404-625-4426
Mailing Address - Fax:800-814-3301
Practice Address - Street 1:3316 S COBB DR SE STE A
Practice Address - Street 2:SUITE 105
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4107
Practice Address - Country:US
Practice Address - Phone:404-625-4426
Practice Address - Fax:800-814-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory