Georgia Department of Public Health

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

044-121 Issued in GA

Legal business name

GEORGIA DEPARTMENT OF PUBLIC HEALTH

Practice address

1749 Clairmont Rd
Decatur, GA 30033-4005

Phone

(404) 327-7900

Fax

(404) 327-7919

NPI assigned

May 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Brenda R. Fitzgerald, M.D.

Title

Commissioner

Phone

(404) 657-2700

Specialties & licenses 1

Addresses

Other names 1

• Georgia Public Health Laboratory Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1417240490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PEACHTREE STREET NW",
            "address_2": "15TH FLOOR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033142",
            "telephone_number": "404-657-2700",
            "fax_number": "404-657-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334005",
            "telephone_number": "404-327-7900",
            "fax_number": "404-327-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DEPARTMENT OF PUBLIC HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-24",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "COMMISSIONER",
        "authorized_official_telephone_number": "404-657-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "044-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Public Health Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Decatur, GA
• Providers in Decatur, 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 May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.