On Demand Diagnostic Lab LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ON DEMAND DIAGNOSTIC LAB LLC

Practice address

3229 Mercer University Dr
Macon, GA 31204-5029

Phone

(404) 655-2292

NPI assigned

Jan 11, 2022

Organization subpart

No

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

Authorized official

Name

Shemicka Johnson

Title

Owner

Phone

(404) 655-2292

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1134870249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6692 DANA DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312205207",
            "telephone_number": "404-655-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3229 MERCER UNIVERSITY DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312045029",
            "telephone_number": "404-655-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON DEMAND DIAGNOSTIC LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHEMICKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-655-2292"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@ondemanddiagnosticlab.com",
            "affiliation": "N",
            "endpointDescription": "company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3229 Mercer University Dr",
            "city": "Macon",
            "state": "GA",
            "country_code": "US",
            "postal_code": "312045029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinic/Center in Macon, GA
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• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.