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NPI Code Detail

MEDICARE: PREMIER LAB & SCREENING LLC

MEDICARE: PREMIER LAB & SCREENING 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 : 1871292649
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER LAB & SCREENING LLC
Provider Business Mailing Address
First Line : 333 TEXAS ST STE 1300
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-3783
Country : US
Telephone Number : 866-961-8774
Fax Number : 318-543-5994
Provider Business Practice Location Address
First Line : 333 TEXAS ST STE 1300
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-3783
Country : US
Telephone Number : 866-961-8774
Fax Number : 318-543-5994
Authorized Official
Title or Position : BUSINESS OWNER/CEO
Name : TAMRA LILLIE
Credential :
Telephone Number : 866-961-8774
Provider Enumeration Date : 03/01/2023
Last Update Date : 03/01/2023

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Directions to “PREMIER LAB & SCREENING LLC ” Practice Location

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