Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE FARMER (DIRECTOR OF LABORATORY SERVICES)
(404) 309-9314
Entity
Organization
Contact information
Practice address
1478 DOGWOOD DR SE, SUITE C, CONYERS, GA 30013-5088
(678) 413-4320
(678) 413-4322
Mailing address
3495 PIEDMONT RD NE, ATLANTA, GA 30305-1717
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
11D2016612
GA
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/05/2011
Last updated
07/15/2021
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