Organization
ONE LAB MOBILE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA ANNETTE SMITH (OWNER)
(770) 356-2916
Entity
Organization
Contact information
Practice address
2405 CAINWOOD CT, CONYERS, GA 30094-8203
(770) 356-2916
(770) 285-4105
Mailing address
2405 CAINWOOD CT, CONYERS, GA 30094-8203
(770) 356-2916
(770) 285-4105
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
HO15-01256
GA
Other
Enumeration date
05/09/2016
Last updated
08/11/2016
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