Confirmatrix Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

12030R Issued in GA

Legal business name

CONFIRMATRIX LABORATORY INC

Practice address

1770 Cedars Rd Ste 200
Lawrenceville, GA 30045-6702

Phone

(678) 407-9818

Fax

(678) 407-9819

NPI assigned

Nov 9, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Ann Durham

Title

Ceo

Phone

(678) 407-9818

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1093069270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 CEDARS RD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300456702",
            "telephone_number": "678-407-9818",
            "fax_number": "678-407-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 CEDARS RD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300456702",
            "telephone_number": "678-407-9818",
            "fax_number": "678-407-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFIRMATRIX LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-09",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-407-9818",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "12030R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003129831A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "11D2047828",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Shaun David Conlon, M.D.

• Clinical Medical Laboratory in Lawrenceville, GA
• Providers in Lawrenceville, 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 9, 2016; 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.