Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Other names
LSUHSC-S Histo Immunology Diganostic Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE H SOTAK MHSA (DIRECTOR OF MANAGED CARE)
(318) 675-7737
Entity
Organization
Contact information
Practice address
1541 KINGS HWY, LSU HISTO IMMUNOLOGY DIAGNOSTIC LAB, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
1541 KINGS HWY, LSU HISTO IMMUNOLOGY DIAGNOSTIC LAB, SHREVEPORT, LA 71103-4228
(318) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1323861
—
LA
Enumeration date
12/01/2006
Last updated
10/23/2007
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