NPI age
14 years
Enumerated 2012-04-06
● Active Type 2 · Organization
Source Diagnostics Of Georgia, Llc
Source Diagnostics Of Georgia, Llc is 1 of 23 clinic/center organizations in Georgia.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Barry
Coo
Last NPPES update
2012-04-06
Source: monthly bulk 2026-05
How this organization compares
Across 23 active clinic/center providers in Georgia.
NPI age
14 years
≈ at median (14 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2012 → 2026
2012-04Enumerated in NPPES
2012
2026
Where they practice
Primary practice location
5559 Thomaston Rd
MacOn, GA 312208120
Mailing address
5275 Naiman Pkwy, Ste E
Solon, OH 441391029
Authorized official
Kathleen A Barry
Coo
📞 4406457822
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.