Polaris Allergy Labs, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

POLARIS ALLERGY LABS, INC.

Practice address

3485 N Desert Dr
Building 2, Suite 206a
East Point, GA 30344-5724

Phone

(404) 419-6311

Fax

(404) 419-6311

NPI assigned

Mar 29, 2011

Organization subpart

No

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

Authorized official

Name

Mr. R. Jackson Garth, MBA, DBA

Title

President/Ceo

Phone

(404) 419-6311

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1073802153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 S COBB DR SE STE A",
            "address_2": "SUITE 215",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804107",
            "telephone_number": "404-419-6311",
            "fax_number": "404-419-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 N DESERT DR",
            "address_2": "BUILDING 2, SUITE 206A",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303445724",
            "telephone_number": "404-419-6311",
            "fax_number": "404-419-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLARIS ALLERGY LABS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "GARTH",
        "authorized_official_first_name": "R. JACKSON",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "404-419-6311",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, DBA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marian Pinnock
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• Alphonso D Porter, LDO
• Lawrence Donald Powell, MD
• Jayaram D Prasad, MD
• Precious L. Braswell, MD, OB/GYN, LLC

• Clinical Medical Laboratory in East Point, GA
• Providers in East Point, 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 Aug 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.