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Organization

ALEXANDRIA PATHOLOGY LABORATORY, LLC

Active
Other names
ROBERTS, PILLARISETTI & MANLAPAZ
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUDHA G PILLARISETTI M.D. (OWNER/PARTNER)
(318) 443-0941
Entity
Organization

Contact information

Practice address
3330 MASONIC DR, LABORATORY, ALEXANDRIA, LA 71301-3841
(318) 443-0941
(318) 443-5734
Mailing address
PO BOX 12116, 3510 PARLIAMENT CT., ALEXANDRIA, LA 71315-2116
(318) 443-0941
(318) 443-5734

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
291U00000X
Clinical Medical Laboratory
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1069922
CIGNA
LA
01
11773
BCBSLA (CLINICAL)
LA
05
1189286
LA
05
1441996
LA
01
CT0606
PALMETTO GBA - RRMC
LA
01
G0919
BCBSLA (ANATOMIC)
LA
Enumeration date
11/08/2005
Last updated
02/10/2010
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