Bioconfirm Laboratories LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BIOCONFIRM LABORATORIES LLC

Practice address

6755 Peachtree Industrial Blvd Suite 150
Doraville, GA 30360

Phone

(770) 449-4193

Fax

(770) 559-4378

NPI assigned

Sep 10, 2015

Organization subpart

No

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

Authorized official

Name

Paula Deanne Crook

Title

Past Credentialing Agent/Ao

Phone

(770) 449-4193

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617235200000",
    "number": "1528436367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6755 PEACHTREE INDUSTRIAL BLVD",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303602223",
            "telephone_number": "770-449-4193",
            "fax_number": "770-559-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6755 PEACHTREE INDUSTRIAL BLVD SUITE 150",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "30360",
            "telephone_number": "770-449-4193",
            "fax_number": "770-559-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOCONFIRM LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-10",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "CROOK",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "DEANNE",
        "authorized_official_title_or_position": "PAST CREDENTIALING AGENT/AO",
        "authorized_official_telephone_number": "770-449-4193"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.