Provider Demographics
NPI:1427800853
Name:THE LAB FAIRIES LLC
Entity type:Organization
Organization Name:THE LAB FAIRIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAMESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-815-5344
Mailing Address - Street 1:2080 ROLLING ROCK CT
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-3651
Mailing Address - Country:US
Mailing Address - Phone:229-815-5344
Mailing Address - Fax:229-800-8061
Practice Address - Street 1:741 PIEDMONT AVE NE STE 300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1420
Practice Address - Country:US
Practice Address - Phone:229-815-5344
Practice Address - Fax:229-800-8061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty