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Individual

SANDRA THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CLP-202351-LAB

Contact information

Practice address
6161 POLARIS DR, BASTROP, LA 71220-3476
(318) 282-4757
Mailing address
6161 POLARIS DR, BASTROP, LA 71220-3476
(318) 282-4757

Taxonomy

Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
CLP-202351-LAB
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
87-2920548
LA
Enumeration date
10/04/2021
Last updated
10/04/2021
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