Healthcare Provider Details

I. General information

NPI: 1467493833
Provider Name (Legal Business Name): CVT VASCULAR LAB, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 HENNESSY BLVD SUITE 1008
BATON ROUGE LA
70808-4300
US

IV. Provider business mailing address

7777 HENNESSY BLVD SUITE 1008
BATON ROUGE LA
70808-4300
US

V. Phone/Fax

Practice location:
  • Phone: 225-766-0416
  • Fax: 225-769-9212
Mailing address:
  • Phone: 225-766-0416
  • Fax: 225-769-9212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number StateLA

VIII. Authorized Official

Name: SOPHIA GUIDRY
Title or Position: LAB DIRECTOR
Credential:
Phone: 225-766-0416