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General NPI Number Information
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NPI Number | 1477566503
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Entity Type | Organization
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Legal Business Name | ADVANCED CYTOLOGY, INC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 217 LA RUE FRANCE
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City | LAFAYETTE
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State | LA
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Zip | 70508-3103
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Country | US
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Telephone | 337-233-5711
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Fax | 337-232-4457
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Provider Business Mailing Address
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Address Line | PO BOX 52607
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City | LAFAYETTE
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State | LA
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Zip | 70505-2607
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Country | US
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Telephone | 337-233-5711
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Fax | 337-232-4457
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Authorized Official
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Title or Position | CEO
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Name | MR. GARY L HILBURN
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Credential |
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Telephone | 337-233-5711
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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 | LA
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