Harbin Clinic, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

057-007 Issued in GA

Legal business name

HARBIN CLINIC, LLC

Doing business as

Harbin Clinic Laboratory

Practice address

1825 Martha Berry Blvd NW
Rome, GA 30165-1625

Phone

(706) 295-5331

Fax

(706) 236-6423

NPI assigned

Jan 15, 2008

Last updated

Feb 5, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

HARBIN CLINIC, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth F. Davis, MD

Title

President

Phone

(762) 235-1000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Harbin Clinic Laboratory Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Harbin Clinic Laboratory

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549324800000",
    "number": "1063698595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651625",
            "telephone_number": "706-295-5331",
            "fax_number": "706-236-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBIN CLINIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HARBIN CLINIC, LLC",
        "enumeration_date": "2008-01-15",
        "last_updated": "2019-02-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "762-235-1000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "057-007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000315609A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbin Clinic Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harbin Clinic Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Rome, GA
• Providers in Rome, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.