Organization
SOUTHEAST DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MILTON A THOMAS JR. (CO-OWNER)
(912) 548-1735
Entity
Organization
Contact information
Practice address
2002 TEBEAU ST, WAYCROSS, GA 31501-6359
(912) 548-1735
(912) 548-1736
Mailing address
2002 TEBEAU ST, WAYCROSS, GA 31501-6359
(912) 548-1735
(912) 548-1736
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/03/2011
Last updated
05/17/2011
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