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General NPI Number Information
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NPI Number | 1396769709
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Entity Type | Organization
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Legal Business Name | LAB SITE INC
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 86 NORTON AVE SUITE 3
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City | ARABI
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State | LA
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Zip | 70032
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Country | US
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Telephone | 504-684-3347
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Fax | 504-684-3346
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Provider Business Mailing Address
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Address Line | 7730 WINDWARD CT
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City | NEW ORLEANS
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State | LA
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Zip | 70128-1339
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Country | US
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Telephone | 504-508-0734
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Fax | 972-291-4304
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Authorized Official
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Title or Position | CEO
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Name | MRS. GAIL J PROVOST
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Credential | MBA HCM
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Telephone | 504-508-0734
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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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