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NPI Code Detail

MEDICARE: PRECISION DIAGNOSTICS LLC

MEDICARE: PRECISION DIAGNOSTICS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1851693220
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRECISION DIAGNOSTICS LLC
Provider Business Mailing Address
First Line : 1304 BERTRAND DR STE E8
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-9105
Country : US
Telephone Number : 337-739-5577
Fax Number :
Provider Business Practice Location Address
First Line : 1304 BERTRAND DR STE E8
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-9105
Country : US
Telephone Number : 337-739-5577
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : JASON MATTHEW WEST
Credential :
Telephone Number : 337-773-9557
Provider Enumeration Date : 11/17/2010
Last Update Date : 05/20/2021

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Directions to “PRECISION DIAGNOSTICS LLC ” Practice Location

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