Organization
HARBIN CLINIC, LLC
Active
Parent organization
HARBIN CLINIC, LLC
Other names
Harbin Clinic Laboratory
Organization subpart
Yes
Provider details
NPI number
Legal business name
HARBIN CLINIC, LLC
Authorized official
KENNETH F. DAVIS MD (PRESIDENT)
(762) 235-1000
Entity
Organization
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 295-5331
(706) 236-6423
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
057-007
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000315609A
—
GA
Enumeration date
01/15/2008
Last updated
02/05/2019
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