Organization · Type 2 NPI

Idesta Medical Inc

Phlebotomy Technician · Tyrone, GA

NPI number 1063185015 Active

Practice location

1015 Tyrone Rd # 410-C
Tyrone, GA 30290-2407

Fax (866) 984-3729

Mailing address

4827 Old National Hwy Unit 2032
College Park, GA 30337-6234

Specialties and licenses

TaxonomyCodeLicense
Blood Banking & Transfusion Medicine Physician 207ZB0001XNone listed
Phlebotomy Technician Primary 246RP1900XNone listed
Clinic/Center 261Q00000XNone listed

Phlebotomy Technician: Definition to come...

Another provider at this address

About NPI 1063185015

Idesta Medical Inc's National Provider Identifier is 1063185015, issued on Jul 27, 2021. The primary taxonomy on file is Phlebotomy Technician (246RP1900X), and the practice location is in Tyrone, GA. The record was last updated on Jun 10, 2026.