DUBLIN INTERNAL MEDICINE REFERENCE LAB (NPI# 1740306315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740306315 |
| Entity Type | Organization |
| Organization Name | DUBLIN INTERNAL MEDICINE REFERENCE LAB |
| Practice Address |
104 Fairview Park Dr Dublin GA 31021-2500 |
| Mailing Address |
Po Box 1528 Dublin GA 31040-1528 |
| Practice Telephone | 4782721366 |
| Practice Fax Number | 4782771922 |
| Mailing Telephone | 4782721366 |
| Mailing Fax Number | 4782771922 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. ELLEN BARR (ASST ADMINISTRATOR) |
| Authorized Official Telephone | 4782721366 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 087-007 | GA | Laboratories |
| Street Address |
104 FAIRVIEW PARK DR |
| City | DUBLIN |
| State | GA |
| Zip Code | 31021-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750369153 | Sandeep C Dsouza | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021 | 2006-01-05 |
| 1982198073 | Hope Pediatrics, LLC | Pediatrics | 104 Fairview Park Dr, Dublin, GA 31021 | 2018-06-21 |
| 1750883435 | Southeast Regional Primary Care Corporation | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2018-03-08 |
| 1124486089 | Crystal A Morgan | Nurse Practitioner | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2016-02-08 |
| 1629441613 | Gastroenterology Associates of Dublin LLC | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2015-11-12 |
| 1992107411 | Dana Lewis Moore | Nurse Practitioner | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2014-09-16 |
| 1457605867 | Dim Physicians LLC | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2012-11-07 |
| 1477870327 | Dublin Gastroenterology Assoc, LLC | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2010-04-30 |
| 1255518890 | Leah Lord Helton | Pediatrics | 104 Fairview Park Dr, Dublin, GA 31021 | 2008-01-25 |
| 1811014939 | Arunasree Chukkapalli | Family Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2007-03-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497213748 | Ronald E. Johnson | Peer Specialist | Carl Vinson Va Medical Center, 1826 Veterans Blvd., Dublin, GA 31021 | 2019-03-06 |
| 1902384811 | Nieka Jackson | Pharmacist | 75 Woodlawn Dr, Apt. C-1, Dublin, GA 31021 | 2018-08-02 |
| 1407341522 | Empower Psychiatry & Weight Loss, LLC | Nurse Practitioner | 112 Rowe St Ste B, Dublin, GA 31021 | 2018-06-30 |
| 1619462207 | Kara Emily Frost | Speech-Language Pathologist | 1406 Bellevue Rd, Dublin, GA 31021 | 2018-06-26 |
| 1376035410 | Owens Speech Services, LLC | Speech-Language Pathologist | 401 Barfield Court, Dublin, GA 31021 | 2018-06-05 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1376991000 | Eatonton Facility Development Company, LLC | Hospice, Inpatient | 155 Greensboro Rd, Eatonton, GA 31021 | 2016-06-03 |
| 1801261177 | Jones Community Health Center, LLC | Clinic/Center | 115 Shadow Pond, Dublin, GA 31021 | 2015-12-11 |
| 1508237561 | Cancer Center of Middle Georgia | Specialist | 26 Erin Office Park, Dublin, GA 31021 | 2015-10-15 |
| 1922477249 | Mickey Jackson | Non-emergency Medical Transport (VAN) | 610 John Robinson Tl., Dublin, GA 31021 | 2015-09-16 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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|---|---|---|---|---|
| 1235508003 | Toxiva | Clinical Medical Laboratory | 6805 Avery Muirfield Dr, Suite 103, Dublin, OH 43016-7180 | 2015-09-22 |
| 1407996317 | Unilab Corporation | Clinical Medical Laboratory | 7802 Dublin Blvd, Dublin, CA 94568-2924 | 2007-02-08 |
| 1932184322 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 6370 Wilcox Rd, Dublin, OH 43016-1269 | 2005-12-08 |
| 1154823953 | Buckeye Clinic | Clinical Medical Laboratory | 6805 Avery Muirfield Dr Ste 103, Dublin, OH 43016-7182 | 2018-03-07 |
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|---|---|---|---|---|
| 1639777899 | White Coat Sciences LLC | Clinical Medical Laboratory | 315 Bankhead Hwy Ste A, Carrollton, GA 30117-2487 | 2020-10-11 |
| 1851998264 | P23 Labs, LLC | Clinical Medical Laboratory | 7426 Hodgson Memorial Dr, Savannah, GA 31406-2609 | 2020-10-08 |
| 1871190686 | Allegiant Solutions LLC | Clinical Medical Laboratory | 3312 N Oak Street Ext Ste G, Valdosta, GA 31605-1065 | 2020-10-05 |
| 1184221376 | Darlene Gordon | Clinical Medical Laboratory | 9100 White Bluff Rd Ste 106, Savannah, GA 31406-4673 | 2020-10-01 |
| 1841807849 | Gold Coast Diagnostics, LLC | Clinical Medical Laboratory | 4390 Governor's Drive, 407, Forest Park, GA 30297-3029 | 2020-09-24 |
| 1154936979 | Achilles Healthcare LLC | Clinical Medical Laboratory | 6183 Indian Wood Cir Se, Mableton, GA 30126-2964 | 2020-09-09 |
| 1033737382 | Community Health and Wellness Lab | Clinical Medical Laboratory | 1039 Ridge Ave Sw, Atlanta, GA 30315-1601 | 2020-07-13 |
| 1497371744 | Gamma Laboratories, LLC | Clinical Medical Laboratory | 270 Carpenter Dr Ste 690, Sandy Springs, GA 30328-4931 | 2020-06-23 |
| 1346864592 | Omega Genomix, LLC | Clinical Medical Laboratory | 200 Washington St Nw Ste C, Gainesville, GA 30501-3622 | 2020-06-03 |
| 1467072231 | Ft Medical Group, LLC | Clinical Medical Laboratory | 777 Cleveland Ave Sw Ste 516, Atlanta, GA 30315-7115 | 2020-04-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.