Organization
NORTHLAKE PATHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY MARK MULA MD (MEDICAL DIRECTOR)
(985) 345-6090
Entity
Organization
Contact information
Practice address
16061 DOCTORS BLVD STE A, HAMMOND, LA 70403-1499
(985) 345-6090
Mailing address
16061 DOCTORS BLVD STE A, HAMMOND, LA 70403-1499
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
108
LA
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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