Organization · NPI-2

Panohealth LLC

Clinical Medical Laboratory · Peachtree Corners, GA

NPI number1467043877
StatusActive
Last updated in NPPESApr 19, 2021

Details

NPI
1467043877
Entity type
Organization (NPI-2)
Legal business name
Panohealth LLC
Organization subpart
No
Enumeration date
Jan 28, 2021
Certification date
Apr 19, 2021
Last updated
Apr 19, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
291U00000X Clinical Medical Laboratory––Yes
261Q00000X Clinic/Center––

Practice location

3607 Parkway Ln Ste 300
Peachtree Corners, GA 30092-2802

Phone 404-712-2012

Mailing address

3607 Parkway Ln Ste 300
Peachtree Corners, GA 30092-2802

Phone 404-712-2012

Authorized official

Kelly Whittaker
Director Health Management Division
4047212012

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