PCL Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PCL LABS LLC

Practice address

4600 E Ponce de Leon Ave Ste B
Clarkston, GA 30021-1839

Phone

(470) 418-4458

NPI assigned

Apr 1, 2022

Last updated

Apr 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dawit Mengesha

Title

President

Phone

(470) 418-4458

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hana Mengesha

  • General Practice Registered Nurse
  • Aurora, CO
  • NPI 1366838971
  NPD

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1457091761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 E PONCE DE LEON AVE STE B",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300211839",
            "telephone_number": "470-418-4458",
            "fax_number": "303-653-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 E PONCE DE LEON AVE STE B",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300211839",
            "telephone_number": "470-418-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCL LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "MENGESHA",
        "authorized_official_first_name": "DAWIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "470-418-4458"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Clarkston, GA
• Providers in Clarkston, 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 Apr 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.