Acadian Diagnostic Laboratories LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ACADIAN DIAGNOSTIC LABORATORIES LLC

Practice address

11842 Justice Ave
Baton Rouge, LA 70816-5324

Phone

(225) 448-5886

NPI assigned

Aug 19, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Terry S Wilks Jr.

Title

Ceo/Owner

Phone

(225) 448-5886

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571961600000",
    "number": "1316370950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11842 JUSTICE AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708165324",
            "telephone_number": "225-448-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11842 JUSTICE AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708165324",
            "telephone_number": "225-448-5886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 S Decker Lake Blvd Ste 4",
            "address_purpose": "LOCATION",
            "city": "West Valley City",
            "state": "UT",
            "postal_code": "841195782",
            "country_code": "US",
            "telephone_number": "225-448-5886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ACADIAN DIAGNOSTIC LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2019-10-25",
        "status": "A",
        "authorized_official_last_name": "WILKS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "225-448-5886",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2352407",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "19D2062876",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Baton Rouge, LA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.