Organization
DOMAIN CLINICAL LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARRY SEATS (COO)
(770) 685-4981
Entity
Organization
Contact information
Practice address
367 ATHENS HWY BLDG 100, LOGANVILLE, GA 30052-2207
(678) 466-6760
Mailing address
PO BOX 492854, LAWRENCEVILLE, GA 30049-0048
(678) 466-6760
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
04/03/2013
Last updated
04/24/2013
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