Organization
MOORE DIAGNOSTIC LABORATORY, INC.
Active
Organization
MOORE DIAGNOSTIC LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLENE JUNE MOORE MT (PRESIDENT/CEO)
(678) 920-0058
Entity
Organization
Contact information
Practice address
5590 MABLETON PKWY SW STE 174, MABLETON, GA 30126-3303
(678) 920-0058
Mailing address
5590 MABLETON PKWY SW STE 174, MABLETON, GA 30126-3303
(678) 920-0058
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/19/2020
Last updated
09/08/2022
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