Organization
GOLGI LABS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DHANUNJAYA R GADDAM (OFFICER)
(678) 294-1826
Entity
Organization
Contact information
Practice address
333 ALCOVY ST STE 4, MONROE, GA 30655-2180
(678) 294-1826
(678) 294-1826
Mailing address
333 ALCOVY ST STE 4, MONROE, GA 30655-2180
(678) 294-1826
(678) 294-1826
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
11D2146695
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D2146695
CLIA #
GA
Enumeration date
04/06/2018
Last updated
04/06/2018
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