Organization
ST. MARYS LABORATORY
Active
Other names
kufoy medical clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNESTO ANTONIO KUFOY MD (PRESIDENT)
(337) 463-3500
Entity
Organization
Contact information
Practice address
311 S PINE ST, DERIDDER, LA 70634-4837
(337) 463-3500
(337) 463-3526
Mailing address
311 S PINE ST, DERIDDER, LA 70634-4837
(337) 463-3500
(337) 463-3526
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
19D1048935
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1666866
—
LA
Enumeration date
12/06/2010
Last updated
12/06/2010
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