Golgi Labs, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

11D2146695 Issued in GA

Legal business name

GOLGI LABS, LLC

Practice address

333 Alcovy St Ste 4
Monroe, GA 30655-2180

Phone

(678) 294-1826

Fax

(678) 294-1826

NPI assigned

Apr 6, 2018

Last updated

Apr 6, 2018By 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

Dhanunjaya R Gaddam

Title

Officer

Phone

(678) 294-1826

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522972800000",
    "number": "1982101929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 ALCOVY ST STE 4",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306552180",
            "telephone_number": "678-294-1826",
            "fax_number": "678-294-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 ALCOVY ST STE 4",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306552180",
            "telephone_number": "678-294-1826",
            "fax_number": "678-294-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLGI LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-04-06",
        "status": "A",
        "authorized_official_last_name": "GADDAM",
        "authorized_official_first_name": "DHANUNJAYA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "678-294-1826"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "11D2146695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "11D2146695",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Elise Gillis, PT, DPT
• John Gipson, RN
• Glenwood Home
• Andrew Goins, R.PH,
• Kathleen Reilly Goldstein, MSPT
• Judy Nell Graves, LPN
• Amanda Kaye Green, PNP
• Charles Goodwin Green, PHARM.D.
• Angela Maria Greene, RN, WHNP-BC
• Lindsey Elizabeth Grieser, APRN

• 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 Apr 6, 2018; 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.