Organization
PEACHTREE LABORATORY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK H DUPUIS MD (SECRETARY TREASURER)
(404) 605-2054
Entity
Organization
Contact information
Practice address
1984 PEACHTREE RD NW, ATLANTA, GA 30309-1298
(800) 288-8325
(404) 609-6766
Mailing address
PO BOX 491028, LAWRENCEVILLE, GA 30049-0053
(404) 605-2054
(404) 609-6766
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300028335A
—
GA
Enumeration date
03/22/2006
Last updated
10/06/2022
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