Lab Star Medical Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

147-004 Issued in GA

Legal business name

LAB STAR MEDICAL LABORATORIES, LLC

Practice address

226 Alcovy St
Ste. a - 1
Monroe, GA 30655-2183

Phone

(770) 266-0613

Fax

(770) 207-4991

NPI assigned

Aug 12, 2006

Organization subpart

No

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

Authorized official

Name

Tim Drake

Title

Owner

Phone

(678) 852-9432

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeff Cohenour, MD

  • Anatomic Pathology Physician
  • Monroe, GA
  • NPI 1760527915
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1760494264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1949",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306551998",
            "telephone_number": "770-266-0613",
            "fax_number": "770-207-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 ALCOVY ST",
            "address_2": "STE. A - 1",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306552183",
            "telephone_number": "770-266-0613",
            "fax_number": "770-207-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAB STAR MEDICAL LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-852-9432"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "147-004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asmira Hajric Khashan
• Bryan Thomas Kirkland, MD
• Rebecca Jo Klemsz, PA
• Keeley Danielle Kooken, LCSW
• Alexander Kushnier, MD
• Amber Morgan Lackey, FNP-C
• Cindy Gissel Laing, DO
• Lacy Elizabeth Lally, DNP, FNP-C
• Betty ABA Lamptey
• Cheryl A Larson, LAC, NMD

• Clinical Medical Laboratory in Monroe, GA
• Providers in Monroe, 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 Feb 2, 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.