OrganizationActive
Complete Wellness Diagnostic Lab, LLC
NPI 1013665355 · Health Service Clinic/Center · Conyers, GA
Provider details
- NPI number
- 1013665355
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Charnika Porter, Owner/Administrator
Practice location
1514 Riverbrooke Way Ne
Conyers, GA 30012-6624
Phone: (678) 643-0885
Mailing address
1514 Riverbrooke Way Ne
Conyers, GA 30012-6624
Registry dates
- Enumerated
- 2022-03-15
- Last updated
- 2022-03-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.