Organization
WEST GEORGIA DIAGNOSTIC TESTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MATRICE BENSON (PRESIDENT)
(678) 777-1917
Entity
Organization
Contact information
Practice address
112 DALTON DR, VILLA RICA, GA 30180-7340
(678) 777-1917
Mailing address
112 DALTON DR, VILLA RICA, GA 30180-7340
(678) 777-1917
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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