Lifetest of Georgia, LLC

Primary specialty

Mammography Clinic/CenterTaxonomy code 261QR0206X

License

BL02-11466 Issued in GA

Legal business name

LIFETEST OF GEORGIA, LLC

Practice address

1140 Hammond Dr NE
Building I, Ste 9120
Atlanta, GA 30328-5338

Phone

(770) 730-0119

Fax

(770) 730-0114

NPI assigned

Jul 13, 2005

Organization subpart

No

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

Authorized official

Name

Lee Gallagher

Title

Executive Director

Phone

(770) 730-0119

Specialties & licenses 2

Addresses

Other names 1

• Lifetest Imaging Center Doing business as

Locations

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1255339107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 HAMMOND DR NE",
            "address_2": "BUILDING I, STE 9120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285338",
            "telephone_number": "770-730-0119",
            "fax_number": "770-730-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 HAMMOND DR NE",
            "address_2": "BUILDING I, STE 9120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285338",
            "telephone_number": "770-730-0119",
            "fax_number": "770-730-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETEST OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-730-0119"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "GA",
            "license": "BL02-11466",
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "GA",
            "license": "BL02-11466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetest Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lifestyle Essentials Transit Corporation
• Lifeworks Wellness,LLC
• Andretta Pearl Lige
• Light Group Services, Inc
• Melissa Light
• Sarah E Light, PT

• Mammography Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Mammography Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.