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Active
Organization subpart
No

Provider details

NPI number
Authorized official
ATHENA ANDREWS (MANAGER)
(318) 834-6913
Entity
Organization

Contact information

Practice address
1844 FULTON ST, SHREVEPORT, LA 71103-4712
(318) 834-6913
Mailing address
PO BOX 29655, SHREVEPORT, LA 71149-9655
(318) 834-6913

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Enumeration date
05/11/2026
Last updated
05/11/2026
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