Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE FARMER (DIRECTOR OF LABORATORY SERVICES)
(404) 309-9314
Entity
Organization
Contact information
Practice address
201 W PONCE DE LEON AVE, SUITE A, DECATUR, GA 30030-3217
(404) 687-7700
(404) 687-7731
Mailing address
3495 PIEDMONT RD NE, ATLANTA, GA 30305-1717
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
11D2000721
GA
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/06/2010
Last updated
07/15/2021
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