Southern Clinical

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

LC40472866D Issued in LA

Legal business name

SOUTHERN CLINICAL

Practice address

86 Norton Ave Ste 3
Arabi, LA 70032-1868

Phone

(504) 335-8938

NPI assigned

Oct 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gail J Provost, MBA/HCM

Title

Ceo

Phone

(504) 335-8938

Specialties & licenses 1

Addresses

Tax ID family

Southern Clinical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Southern Clinical Laboratory

  • Clinical Medical Laboratory
  • Arabi, LA
  • NPI 1639465677
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1285986984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 NORTON AVE",
            "city": "ARABI",
            "state": "LA",
            "postal_code": "700321868",
            "telephone_number": "504-335-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 NORTON AVE STE 3",
            "city": "ARABI",
            "state": "LA",
            "postal_code": "700321868",
            "telephone_number": "504-335-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CLINICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "PROVOST",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-335-8938",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA/HCM"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "LA",
            "license": "LC40472866D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Pilet, RN
• Brooke L Pitre
• Doris Marie Reed
• Russell Roy Jr.
• Ronald Ruffin, RN
• Southern Clinical Laboratory
• Elizabeth Catherine Spence, CPNP
• St. Bernard Health Center, Inc
• St. Bernard Health Center, Inc.
• Take Care Clinic LLC

• Clinical Medical Laboratory in Arabi, LA
• Providers in Arabi, LA by specialty
• Clinical Medical Laboratory in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.