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General NPI Number Information
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NPI Number | 1518619691
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Entity Type | Organization
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Legal Business Name | TRULAB DIAGNOSTICS LLC
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 178 BAKER RD
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City | INDEPENDENCE
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State | LA
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Zip | 70443-4742
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Country | US
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Telephone | 985-474-2114
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Fax | 985-247-2254
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Provider Business Mailing Address
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Address Line | 178 BAKER RD
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City | INDEPENDENCE
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State | LA
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Zip | 70443-4742
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Country | US
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Telephone | 985-474-2114
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Fax | 985-247-2254
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | REGINA R NICHOLES
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Credential | LPN
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Telephone | 985-474-2114
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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