American Clinical Laboratory,Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

044-126 Issued in GA

Legal business name

AMERICAN CLINICAL LABORATORY,INC

Practice address

5500B Lilburn Stone Mountain Rd
Stone Mountain, GA 30087-2841

Phone

(770) 717-8801

Fax

(770) 717-8808

NPI assigned

Jul 17, 2006

Last updated

Apr 15, 2008By 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

Dr. Arun K Khanna, PHD

Title

President/Ceo

Phone

(770) 717-8801

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1679590236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500B LILBURN STONE MOUNTAIN RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872841",
            "telephone_number": "770-717-8801",
            "fax_number": "770-717-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500B LILBURN STONE MOUNTAIN RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872841",
            "telephone_number": "770-717-8801",
            "fax_number": "770-717-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN CLINICAL LABORATORY,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "KHANNA",
        "authorized_official_first_name": "ARUN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "770-717-8801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "044-126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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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 15, 2008; 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.