Provider Demographics
NPI:1215477583
Name:AMERICAN MEDICAL LABORATORIES AND TREATMENT CENTERS
Entity type:Organization
Organization Name:AMERICAN MEDICAL LABORATORIES AND TREATMENT CENTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MECHWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-815-6393
Mailing Address - Street 1:821 DAWSONVILLE HWY
Mailing Address - Street 2:BUILDING 250 SUITE 101
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2636
Mailing Address - Country:US
Mailing Address - Phone:678-936-4675
Mailing Address - Fax:
Practice Address - Street 1:821 DAWSONVILLE HWY
Practice Address - Street 2:BUILDING 250 SUITE 101
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2636
Practice Address - Country:US
Practice Address - Phone:678-936-4675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory