Organization
HEMATOLOGY ONCOLOGY LIFE CENTER PRESCOTT
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
2003 MACARTHUR DR, STE 5, ALEXANDRIA, LA 71301-3720
(318) 619-7707
(318) 619-7771
Mailing address
PO BOX 8255, ALEXANDRIA, LA 71306-1255
(318) 442-2232
(318) 442-2192
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
19D1020000
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19D1020000
CLIA ID #
LA
Enumeration date
05/23/2005
Last updated
06/19/2008
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