GRANDS PREMIER HEALTH & LAB DIAGNOSTICS LLC NPI 1184376931

NPI Information

  • NPI: 1184376931
  • Provider Name: GRANDS PREMIER HEALTH & LAB DIAGNOSTICS LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • CLIA Number: 11D2250828
  • Address: 3347 SURVEYOR CT
    DOUGLASVILLE, GA
    ZIP 30135
  • Phone: (770) 990-4699

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NPI Details

GRANDS PREMIER HEALTH & LAB DIAGNOSTICS LLC is a clinic center in Douglasville, GA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). GRANDS PREMIER HEALTH & LAB DIAGNOSTICS LLC NPI is 1184376931. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3347 SURVEYOR CT
DOUGLASVILLE, GA
ZIP 30135-102
Phone: (770) 990-4699

The provider's authorized official is Shantel Antoin Brown .
The authorized official title is Owner and has the following contact phone number (770) 990-4699.

The CLIA number assigned to this NPI record is 11D2250828 - other - diagnostic test fac with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/24/2022 and was last updated on 2/16/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered NurseNo
2291U00000XClinical Medical LaboratoryNo
3363LF0000XNurse PractitionerFamilyNo
4261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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