BLOOD DIAMOND MOBILE LABORATORY LLC NPI 1184472441

NPI Information

  • NPI: 1184472441
  • Provider Name: BLOOD DIAMOND MOBILE LABORATORY LLC
  • Classification: Technician, Pathology - 246RP1900X
  • Specialization: Phlebotomy
  • Entity Type: Organization
  • Doing Business As: BLOOD DIAMOND MOBILE LABORATORY LLC
  • CLIA Number: 11D2309462
  • Address: 1212 RIVER RUSH LN NE
    CONYERS, GA
    ZIP 30012
  • Phone: (770) 875-3947

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NPI Details

BLOOD DIAMOND MOBILE LABORATORY LLC is a phlebotomy technician pathology in Conyers, GA. BLOOD DIAMOND MOBILE LABORATORY LLC NPI is 1184472441. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Blood Diamond Mobile Laboratory Llc.

The provider's business location address is:

1212 RIVER RUSH LN NE
CONYERS, GA
ZIP 30012-613
Phone: (770) 875-3947

The provider's authorized official is Roxann A Dooling .
The authorized official title is Owner/ Phlebotomist and has the following contact phone number (770) 875-3947.

The CLIA number assigned to this NPI record is 11D2309462 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2024 and was last updated on 8/23/2024.

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
1246RP1900XTechnician, PathologyPhlebotomyYes
2261QH0100XClinic/CenterHealth ServiceNo

What is NPI?

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

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