Organization
EXCEL DIAGNOSTIC LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE H. RUSSELL III (TECHNICAL DIRECTOR)
(404) 219-0912
Entity
Organization
Contact information
Practice address
2740 JEFFERSON ST, SUITE B, AUSTELL, GA 30168-4014
(404) 219-0912
Mailing address
2740 JEFFERSON ST, SUITE B, AUSTELL, GA 30168-4014
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
033-109
GA
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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