Provider Demographics
NPI:1730628439
Name:OXY-GEN LABORATORY LLC
Entity type:Organization
Organization Name:OXY-GEN LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN FRANCOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TOURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-771-2925
Mailing Address - Street 1:5680 OAKBROOK PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1841
Mailing Address - Country:US
Mailing Address - Phone:770-686-3620
Mailing Address - Fax:888-316-1232
Practice Address - Street 1:303 RESEARCH DR STE 300
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-7001
Practice Address - Country:US
Practice Address - Phone:770-686-3620
Practice Address - Fax:888-316-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic PathologyGroup - Multi-Specialty