Organization
THE LABORATORY OF LEESVILLE, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUHAMMAD ANWAR MOLANI M.D. (PRESIDENT)
(337) 239-5496
Entity
Organization
Contact information
Practice address
1020 W FERTITTA BLVD, LEESVILLE, LA 71446-4649
(337) 239-5496
(337) 239-5387
Mailing address
PO BOX 679, LEESVILLE, LA 71496-0679
(337) 239-5496
(337) 239-5387
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
12708R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011789
—
LA
01
—
174358900
WORKMAN'S COMP
LA
01
—
2236504350
BCBS PROVIDER #
LA
01
—
7203091
AETNA/US HEALTHCARE
LA
Enumeration date
10/04/2006
Last updated
08/29/2008
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