Express Medical Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EXPRESS MEDICAL LAB LLC

Practice address

1200 Highway 74 S Ste 3
Peachtree City, GA 30269-3071

Phone

(678) 704-5656

NPI assigned

Jul 1, 2017

Organization subpart

No

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

Authorized official

Name

Tameka S Sykes, ASCP

Title

Lab Technician

Phone

(678) 704-5656

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1498867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1891216628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HIGHWAY 74 S STE 3",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693071",
            "telephone_number": "678-704-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HIGHWAY 74 S STE 3",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693071",
            "telephone_number": "678-704-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS MEDICAL LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-01",
        "last_updated": "2022-07-21",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "SYKES",
        "authorized_official_first_name": "TAMEKA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "LAB TECHNICIAN",
        "authorized_official_telephone_number": "678-704-5656",
        "authorized_official_credential": "ASCP"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.