Organization
SOUTH EAST ARKANSAS LAB & SCR SVCS
Active
Parent organization
SOUTH EAST ARK. LABORATORY & SCR SVCS
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH EAST ARK. LABORATORY & SCR SVCS
Authorized official
MR. ROBERT A. ROSEN BS PD (PRESIDENT)
(870) 534-6699
Entity
Organization
Contact information
Practice address
201 S MAIN ST, PINE BLUFF, AR 71601
(870) 534-6699
Mailing address
201 S MAIN ST, PINE BLUFF, AR 71601
(870) 534-6699
(870) 534-6699
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
04D1059019
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164955709
—
AR
Enumeration date
07/30/2007
Last updated
02/23/2009
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