Organization
ATLANTA CLINICAL LABORATORIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLYDE OCTAVIUS GREEN M.D. (LABORATORIE DIRECTOR)
(478) 742-8205
Entity
Organization
Contact information
Practice address
1122 GRAY HWY STE 3, MACON, GA 31211-3206
(478) 742-8205
(478) 743-8072
Mailing address
1122 GRAY HWY STE 3, MACON, GA 31211-3206
(478) 742-8205
(478) 743-8072
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
0640536
GA
Other
Enumeration date
03/27/2007
Last updated
01/14/2008
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