Organization
SOUTHERN LAB SPECIALTIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA KAYE CELESTINE PHLEBOTOMIST (OWNER)
(337) 515-7016
Entity
Organization
Contact information
Practice address
3505 5TH AVE, SUITE A1, LAKE CHARLES, LA 70607-2156
(337) 515-7016
(337) 313-0019
Mailing address
PO BOX 381, LAKE CHARLES, LA 70602-0381
(337) 515-7016
(337) 313-0019
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLP.P00122-PHL
LA
Other
Enumeration date
01/26/2009
Last updated
01/26/2009
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