Organization
HEMATOLOGY ONCOLOGY LIFE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD G WOLD M.D. (LABORATORY DIRECTOR)
(318) 442-2232
Entity
Organization
Contact information
Practice address
605B MEDICAL CENTER DR, ALEXANDRIA, LA 71301-8127
(318) 442-2232
(318) 442-2192
Mailing address
605 MEDICAL CENTER DR STE B, ALEXANDRIA, LA 71301-8145
(318) 442-2232
(318) 442-2192
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
19D0464720
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19D0464720
CLIA ID #
LA
Enumeration date
05/25/2005
Last updated
06/25/2020
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