Active NPI
Blessed Hands Mobile Lab
- Medical Laboratory Technician
- Fayetteville, GA
National Provider Identifier
1417608522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Laboratory Technician
- Legal business name
- BLESSED HANDS MOBILE LAB
- Practice address
- 320 Lanier Ave W Ste 200
Fayetteville, GA 30214-7443 - Phone
- (678) 696-7896
- NPI assigned
- Jan 11, 2022
- Last updated
- Feb 21, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Shirley Solomon
- Title
- Admin
- Phone
- (678) 651-3395
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Laboratory Technician | 246RM2200X | NU | Primary |
Addresses
Primary practice location
320 Lanier Ave W Ste 200
Fayetteville, GA 30214-7443
Mailing address
106 Meadow Creek CT
Hampton, GA 30228-5553
Phone (678) 696-7896
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2240968 | Blessed Hands Mobile Lab | Certificate of waiver | Oct 24, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Blessed Hands Home Care LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- In Home Supportive Care Agency
- Hampton, GA
- NPI 1801441449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641859200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1645401600000",
"number": "1417608522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 MEADOW CREEK CT",
"city": "HAMPTON",
"state": "GA",
"postal_code": "302285553",
"telephone_number": "678-696-7896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 LANIER AVE W STE 200",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147443",
"telephone_number": "678-696-7896"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLESSED HANDS MOBILE LAB",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-11",
"last_updated": "2022-02-21",
"certification_date": "2022-02-21",
"status": "A",
"authorized_official_last_name": "SOLOMON",
"authorized_official_first_name": "SHIRLEY",
"authorized_official_title_or_position": "ADMIN",
"authorized_official_telephone_number": "678-651-3395",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "246RM2200X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Medical Laboratory",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.