Organization
PHYSICIAN LABORATORY CONSULTANTS LLC
Active
Parent organization
PATHOLOGY ASSOCIATES, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PATHOLOGY ASSOCIATES, PC
Authorized official
JANET TANNER (CREDENTIALING)
(229) 228-6496
Entity
Organization
Contact information
Practice address
130 N BROAD ST, THOMASVILLE, GA 31792-8132
(800) 899-5757
Mailing address
PO BOX 78545, SAINT LOUIS, MO 63178-8545
(800) 899-5757
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300030489A
—
GA
Enumeration date
10/23/2013
Last updated
07/11/2016
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