Organization
HIBISCUS LAB SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEENA CLARKE RN (OWNER)
(770) 485-9050
Entity
Organization
Contact information
Practice address
376 MAXHAM RD STE D, AUSTELL, GA 30168-8317
(718) 679-1620
Mailing address
669 TOMAHAWK PL, AUSTELL, GA 30168-6339
(718) 679-1620
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
01/19/2022
Last updated
02/16/2022
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