Organization
ADVANCED DIAGNOSTICS LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA R BAYLIN (COO)
(770) 371-7711
Entity
Organization
Contact information
Practice address
1030 KINGS HWY N STE 304, CHERRY HILL, NJ 08034-1907
(856) 320-2143
(856) 320-2147
Mailing address
950 EAGLES LANDING PKWY # 133, STOCKBRIDGE, GA 30281-7343
(856) 320-2143
(856) 320-2147
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
0012217
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003258190A
—
GA
05
—
2637037
—
LA
Enumeration date
07/10/2018
Last updated
01/11/2024
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