Organization
HEALING HANDS DIAGNOSTIC LAB LLC
Active
Other names
Healing Hands Diagnostic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STACI SLACK (CHIEF EXECUTIVE OFFICER)
(678) 387-9409
Entity
Organization
Contact information
Practice address
2256 NORTHLAKE PKWY STE 110, TUCKER, GA 30084-4012
(678) 387-9409
(470) 300-7993
Mailing address
4440 IDLEWOOD PARK, LITHONIA, GA 30038-6247
(678) 387-9409
(470) 401-2551
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
291900000X
Military Clinical Medical Laboratory
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003187979
—
GA
Enumeration date
02/10/2022
Last updated
09/02/2025
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