One Lab Mobile, LLC

Primary specialty

Other TechnicianTaxonomy code 247200000X

License

HO15-01256 Issued in GA

Legal business name

ONE LAB MOBILE, LLC

Practice address

2405 Cainwood CT
Conyers, GA 30094-8203

Phone

(770) 356-2916

Fax

(770) 285-4105

NPI assigned

May 9, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Pamela Annette Smith

Title

Owner

Phone

(770) 356-2916

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1124474143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 CAINWOOD CT",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300948203",
            "telephone_number": "770-356-2916",
            "fax_number": "770-285-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 CAINWOOD CT",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300948203",
            "telephone_number": "770-356-2916",
            "fax_number": "770-285-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE LAB MOBILE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-356-2916",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Other",
            "state": "GA",
            "license": "HO15-01256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Other Technician in Conyers, GA
• Providers in Conyers, GA by specialty
• Other Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.