Provider Demographics
NPI:1952582470
Name:DIAGNOSTIC LABORATORY SERVICES INC.
Entity Type:Organization
Organization Name:DIAGNOSTIC LABORATORY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:PAJEAUD
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-438-2334
Mailing Address - Street 1:PO BOX 920801
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30010-0801
Mailing Address - Country:US
Mailing Address - Phone:404-438-2334
Mailing Address - Fax:
Practice Address - Street 1:1840 WOODLAND RUN TRL
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-5874
Practice Address - Country:US
Practice Address - Phone:404-438-2334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty