Individual provider · Type 1 NPI
Mary Latrelle Reese
Clinical Laboratory Director (Non-physician) · East Point, GA
NPI number
1649089566
Active
Practice location
1393 Cleveland Ave Ste 107EAST
East Point, GA 30344-3423
Mailing address
290 Montego Cir
Riverdale, GA 30274-3617
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Laboratory Director (Non-physician) Primary | 247ZC0005X | None listed |
Clinical Laboratory Director (Non-physician): An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405.
About NPI 1649089566
Mary Latrelle Reese's National Provider Identifier is 1649089566, issued on Jan 6, 2025. The primary taxonomy on file is Clinical Laboratory Director (Non-physician) (247ZC0005X), and the practice location is in East Point, GA. The record was last updated on Jan 6, 2025.