NPIMap

Organization Active NPI

MD Precision Lab

  • Clinical Medical Laboratory
  • Conyers, GA
National Provider Identifier
1932507423
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MD PRECISION LAB
Practice address
1380 Milstead Ave NE
Ste J
Conyers, GA 30012-3864
Phone
(770) 760-9360
NPI assigned
Dec 15, 2014
Last updated
Dec 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Authorized official

Name
Roy Talley, MDNPI 1396732657
Title
President
Phone
(770) 760-9360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1380 Milstead Ave NE
Ste J
Conyers, GA 30012-3864

Mailing address

1380 Milstead Ave NE
Ste J
Conyers, GA 30012-3864
Phone (770) 760-9360

National Provider Directory

National Provider Directory

Locations

1380 Milstead Ave NE
Ste J
Conyers, GA 30012
Phone (770) 760-9360

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418601600000",
    "number": "1932507423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 MILSTEAD AVE NE",
            "address_2": "STE J",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123864",
            "telephone_number": "770-760-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 MILSTEAD AVE NE",
            "address_2": "STE J",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123864",
            "telephone_number": "770-760-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD PRECISION LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-15",
        "last_updated": "2014-12-15",
        "status": "A",
        "authorized_official_last_name": "TALLEY",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-760-9360",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.