Provider Demographics
NPI:1881938082
Name:ALL CLINICAL LABS,LLC
Entity type:Organization
Organization Name:ALL CLINICAL LABS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRIER- THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DSM
Authorized Official - Phone:770-898-8842
Mailing Address - Street 1:815 PAVILION CT
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-6666
Mailing Address - Country:US
Mailing Address - Phone:770-898-8842
Mailing Address - Fax:770-898-8085
Practice Address - Street 1:815 PAVILION CT
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-6666
Practice Address - Country:US
Practice Address - Phone:770-898-8842
Practice Address - Fax:770-898-8085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10113997291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory