Placebo Group, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PLACEBO GROUP, LLC

Doing business as

INFINITY LABORATORY, LLC

Practice address

2075 W Park Place Blvd Ste B
Stone Mountain, GA 30087-3542

Phone

(404) 410-9114

Fax

(404) 521-4665

NPI assigned

Apr 6, 2021

Organization subpart

No

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

Authorized official

Name

Khalil Shafiq

Title

Owner

Phone

(404) 410-9114

Specialties & licenses 1

Addresses

Other names 1

• INFINITY LABORATORY, LLC Doing business as

Locations

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1528647591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 W PARK PLACE BLVD STE B",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873542",
            "telephone_number": "404-410-9114",
            "fax_number": "404-521-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 W PARK PLACE BLVD STE B",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873542",
            "telephone_number": "404-410-9114",
            "fax_number": "404-521-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACEBO GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "SHAFIQ",
        "authorized_official_first_name": "KHALIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-410-9114"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INFINITY LABORATORY, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Stone Mountain, GA
• Providers in Stone Mountain, 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 6, 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.