Moore Diagnostic Laboratory, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MOORE DIAGNOSTIC LABORATORY, INC.

Practice address

5590 Mableton Pkwy SW Ste 174
Mableton, GA 30126-3303

Phone

(678) 920-0058

NPI assigned

Oct 19, 2020

Last updated

Sep 8, 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

Mrs. Marlene June Moore, MT

Title

President/Ceo

Phone

(678) 920-0058

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1629677034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5590 MABLETON PKWY SW STE 174",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301263303",
            "telephone_number": "678-920-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5590 MABLETON PKWY SW STE 174",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301263303",
            "telephone_number": "678-920-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE DIAGNOSTIC LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "678-920-0058",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind and Body Therapy Ga, LLC
• Robyn N Minefee, LPC
• Yasmine Marie Minnifield
• William Clifford Mobley, M.D.
• Lens Moise
• Jeida Moore, CNA
• Lorraine Benson Moore, M.ED.
• Sirena Morris
• Jamia Morrow, LPC
• Mortuary Artists, Inc.

• Clinical Medical Laboratory in Mableton, GA
• Providers in Mableton, 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 Sep 8, 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.