Elite Medical Laboratories Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ELITE MEDICAL LABORATORIES INC

Practice address

1130 Hurricane Shoals Rd NE Ste 1300
Lawrenceville, GA 30043-4871

Phone

(706) 400-4295

Fax

(770) 545-8523

NPI assigned

Jul 13, 2017

Last updated

Sep 19, 2019By 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

Walid M Diab

Title

Owner

Phone

(404) 451-7241

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1710409545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 HURRICANE SHOALS RD NE STE 1300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434871",
            "telephone_number": "404-451-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 HURRICANE SHOALS RD NE STE 1300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434871",
            "telephone_number": "706-400-4295",
            "fax_number": "770-545-8523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MEDICAL LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "DIAB",
        "authorized_official_first_name": "WALID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-451-7241"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Lawrenceville, GA
• Providers in Lawrenceville, 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 19, 2019; 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.