Organization Active NPI

Blessed Hands Mobile Lab

  • Medical Laboratory Technician
  • Fayetteville, GA
National Provider Identifier
1417608522
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Laboratory TechnicianTaxonomy code 246RM2200X
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, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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)CodeLicenseStatePrimary
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 NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2240968Blessed Hands Mobile Lab320 W Lanier Avenue Suite 200, Fayetteville, GA 30214Certificate of waiverOct 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Blessed Hands Home Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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.

Verify at the official NPI Registry.