NPI age
4 years
Enumerated 2022-03-02
● Active Type 2 · Organization
Fourth Wall Testing Llc
Fourth Wall Testing Llc is 1 of 621 clinical medical laboratory organizations in Georgia.
Primary specialty
Clinical Medical Laboratory
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Wilson
President
Last NPPES update
2022-10-12
Source: monthly bulk 2026-05
How this organization compares
Across 621 active clinical medical laboratory providers in Georgia.
NPI age
4 years
≈ at median (5 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2022 → 2026
2022-03Enumerated in NPPES
2022
2026
Where they practice
Primary practice location
11705 Jones Bridge Rd Ste B101
Johns Creek, GA 300055080
Mailing address
712 S Ocean Shore Blvd # 217
Flagler Beach, FL 321363602
Authorized official
Lisa Wilson
President
📞 3526300886
Specialties
-
Clinical Medical Laboratory Primary(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human...
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 →
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