| Four Corners Testing LLC | |
|
4050 Ga-42 Locust Grove GA 30248 | |
| (206) 371-3336 | |
| Not Available |
| Full Name | Four Corners Testing LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 4050 Ga-42, Locust Grove, Georgia |
| Authorized Official Name and Position | Bryan Jones (PRINCIPAL) |
| Authorized Official Contact | 2063713336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Corners Testing LLC 14150 Ne 20th St # F1-282 Bellevue WA 98007-3700 | Four Corners Testing LLC 4050 Ga-42 Locust Grove GA 30248 Ph: (206) 371-3336 |
| NPI Number | 1194431718 |
|---|---|
| Provider Enumeration Date | 01/26/2023 |
| Last Update Date | 01/26/2023 |
| Certification Date | 01/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194431718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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