NPIMap

Organization Active NPI

Elite Diagnostics Labs, Inc

  • Clinical Medical Laboratory
  • Lawrenceville, GA
National Provider Identifier
1104363746
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
ELITE DIAGNOSTICS LABS, INC
Practice address
1130 Hurricane Shoals Rd NE
Suite 1300
Lawrenceville, GA 30043-4851
Phone
(844) 854-8556
Fax
(770) 338-1994
NPI assigned
Jan 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Stanley Wu, PH.D
Title
Authorized Official
Phone
(844) 854-8556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1130 Hurricane Shoals Rd NE
Suite 1300
Lawrenceville, GA 30043-4851

Mailing address

1130 Hurricane Shoals Rd NE
Suite 1300
Lawrenceville, GA 30043-4851
Phone (844) 854-8556

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1104363746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 HURRICANE SHOALS RD NE",
            "address_2": "SUITE 1300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434851",
            "telephone_number": "844-854-8556",
            "fax_number": "770-338-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 HURRICANE SHOALS RD NE",
            "address_2": "SUITE 1300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434851",
            "telephone_number": "844-854-8556",
            "fax_number": "770-338-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DIAGNOSTICS LABS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "844-854-8556",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.