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General NPI Number Information
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NPI Number | 1013661305
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Entity Type | Organization
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Legal Business Name | CAJUN CLINICAL LABORATORY SERVICES, LLC
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 02/07/2022
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Provider Practice Location Address
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Address Line | 14086 AIRLINE HWY APT 2026
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City | GONZALES
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State | LA
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Zip | 70737-0619
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Country | US
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Telephone | 225-461-5323
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 314
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City | DUPLESSIS
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State | LA
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Zip | 70728-0314
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Country | US
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Telephone | 225-461-5323
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. EVELYN DARNELL PERKINS
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Credential | REGISTERED NURSE
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Telephone | 225-461-5323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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