Provider Demographics
NPI:1902552946
Name:A1 DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:A1 DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNETRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOLLICOFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-499-5745
Mailing Address - Street 1:9842 BOSQUE CREEK CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-5154
Mailing Address - Country:US
Mailing Address - Phone:678-499-5745
Mailing Address - Fax:
Practice Address - Street 1:3225 CREEK TRCE W
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-9055
Practice Address - Country:US
Practice Address - Phone:678-499-5745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical LaboratoryGroup - Multi-Specialty
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty