Healthcare Provider Details

I. General information

NPI: 1992483341
Provider Name (Legal Business Name): CLINICAL LYNKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 SEVERN AVE STE 404
METAIRIE LA
70002-5955
US

IV. Provider business mailing address

116 BROOKTER ST
SLIDELL LA
70461-3508
US

V. Phone/Fax

Practice location:
  • Phone: 504-606-7576
  • Fax:
Mailing address:
  • Phone: 504-606-7576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: MISS KWANZA QUINEISE GAINES
Title or Position: CEO
Credential:
Phone: 504-606-7576