Organization
LABORATORY DOCTORS NETWORK LLC
Active
Parent organization
ILAMAE PRICE LLC
Other names
LABORATORY DOCTORS NETWORK LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ILAMAE PRICE LLC
Authorized official
ILA WALKER MT (DIRECTOR OF LABORATORY SERVICES)
(404) 551-2799
Entity
Organization
Contact information
Practice address
612 MAIN ST STE 102, PALMETTO, GA 30268-1149
(404) 551-2799
(678) 834-5529
Mailing address
612 MAIN ST STE 102, PALMETTO, GA 30268-1149
(404) 551-2799
(678) 834-5529
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D2184009
CMS CLIA CERTIFICATE OF WAIVER
GA
Enumeration date
09/16/2021
Last updated
10/25/2021
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