Organization
CHATTAHOOCHEE PHYSICIANS LABORATORY SERVICES, LLC
Active
Organization
CHATTAHOOCHEE PHYSICIANS LABORATORY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE BAUER (LAB ADMINISTRATOR)
(770) 674-4468
Entity
Organization
Contact information
Practice address
1122 CAMBRIDGE SQ, STE E, ALPHARETTA, GA 30009-1858
(770) 674-4468
(770) 209-2366
Mailing address
1122 CAMBRIDGE SQ, STE E, ALPHARETTA, GA 30009-1858
(770) 674-4468
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003184390A
—
GA
05
—
1124409958
—
ID
Enumeration date
06/17/2015
Last updated
03/21/2017
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