Organization
NORTHEAST SUPPORTS AND SERVICES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET ROBINSON (DIRECTOR OF ADMINISTRATIVE SERVICES)
(318) 247-4213
Entity
Organization
Contact information
Practice address
2776 HIGHWAY 150, RUSTON, LA 71270-1500
(318) 247-4213
(318) 247-4254
Mailing address
PO BOX 907, RUSTON, LA 71273-0907
(318) 247-4213
(318) 247-4254
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1886726
—
LA
Enumeration date
09/29/2009
Last updated
09/29/2009
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