# EARLY DETECTION SCREENINGS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497135362
- **Authorized official:** TRACI G OLIVIER (MANAGER)
- **Authorized official phone:** (337) 331-5995

## Contact information

- **Practice address:** 110 HOSPITAL DR, LAFAYETTE, LA 70503-2819
- **Practice address phone:** (337) 232-4150
- **Practice address fax:** (337) 232-2990
- **Mailing address:** 110 HOSPITAL DR, LAFAYETTE, LA 70503-2819
- **Mailing address phone:** (337) 232-4150
- **Mailing address fax:** (337) 232-2990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0208X | Mobile Radiology Clinic/Center | 96204 | LA | Yes |

## Other

- **Enumeration date:** 06/04/2015
- **Last updated:** 06/04/2015