Organization
IPSUM DIAGNOSTICS LLC
Active
Organization
IPSUM DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA LEBERTE (CREDENTIALING MANAGER)
(309) 322-8931
Entity
Organization
Contact information
Practice address
8607 ROBERTS DR STE 250, ATLANTA, GA 30350-2237
(678) 915-2299
(833) 964-0184
Mailing address
8607 ROBERTS DR STE 250, ATLANTA, GA 30350-2237
(678) 915-2299
(833) 964-0184
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
11D2125186
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003198560A
—
GA
01
—
060-403
GA LICENSE
GA
05
—
397268901
—
TX
01
—
45D2299234
CLIA NUMBER
TX
Enumeration date
02/28/2017
Last updated
02/24/2026
Update your record
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