Organization
GULF COAST MOLECULAR LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES POTTER (ADMINISTRATOR)
(251) 494-2540
Entity
Organization
Contact information
Practice address
11617 HWY 31, UNIT 3, SPANISH FORT, AL 36527
(251) 494-2540
(205) 374-8606
Mailing address
11617 HWY 31, UNIT 3, SPANISH FORT, AL 36527
(251) 494-2540
(251) 930-6727
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227036
—
AL
05
—
427926701
—
TX
Enumeration date
07/13/2018
Last updated
03/01/2022
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