Organization
PM LAB SOURCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA MCLAUGHLIN NP (DIRECTOR)
(706) 914-8400
Entity
Organization
Contact information
Practice address
8201 PRESERVATION TRL, MIDLAND, GA 31820-3667
(706) 914-8400
Mailing address
8201 PRESERVATION TRL, MIDLAND, GA 31820-3667
(706) 914-8400
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477713675
—
GA
Enumeration date
04/30/2022
Last updated
04/30/2022
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