Organization
EMERGENT TESTING LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN GOSS MD (OWNER)
(713) 819-6417
Entity
Organization
Contact information
Practice address
13 CORPORATE BLVD NE STE 250, BROOKHAVEN, GA 30329-1901
(678) 941-4278
Mailing address
13 CORPORATE BLVD NE STE 250, BROOKHAVEN, GA 30329-1901
(470) 467-0124
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/10/2020
Last updated
10/04/2023
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