OrganizationActive
360 Laboratories, LLC
NPI 1871024273 · Clinical Medical Laboratory · Norcross, GA
Provider details
- NPI number
- 1871024273
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Authorized official
- Fadi Elkhatib, Owner
- License
- 067-078 (GA)
Practice location
1180 Beaver Ruin Rd
Suite a
Norcross, GA 30093-6801
Phone: (678) 235-4212
Fax: (678) 399-3659
Mailing address
1180 Beaver Ruin Rd
Norcross, GA 30093-6801
Registry dates
- Enumerated
- 2017-03-27
- Last updated
- 2019-09-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.