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General NPI Number Information
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NPI Number | 1215686787
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Entity Type | Organization
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Legal Business Name | LE'FEATHER LAB SERVICES LLC
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 341 W LACEY RD
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City | MONTICELLO
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State | AR
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Zip | 71655-9632
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Country | US
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Telephone | 501-289-3507
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Fax |
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Provider Business Mailing Address
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Address Line | 150 RIDGECREST AVE
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City | BASTROP
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State | LA
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Zip | 71220-2351
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. JERRIE DANIELS
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Credential |
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Telephone | 501-289-3507
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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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