Southern Lab Specialties, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLP.P00122-PHL Issued in LA

Legal business name

SOUTHERN LAB SPECIALTIES, INC

Practice address

3505 5TH Ave
Suite A1
Lake Charles, LA 70607-2156

Phone

(337) 515-7016

Fax

(337) 313-0019

NPI assigned

Jan 26, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Brenda Kaye Celestine, PHLEBOTOMIST

Title

Owner

Phone

(337) 515-7016

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232928000000",
    "number": "1346488640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706020381",
            "telephone_number": "337-515-7016",
            "fax_number": "337-313-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 5TH AVE",
            "address_2": "SUITE A1",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706072156",
            "telephone_number": "337-515-7016",
            "fax_number": "337-313-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN LAB SPECIALTIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-01-26",
        "status": "A",
        "authorized_official_last_name": "CELESTINE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "KAYE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-515-7016",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHLEBOTOMIST"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "LA",
            "license": "CLP.P00122-PHL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Lake Charles, LA
• Providers in Lake Charles, 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 Jan 26, 2009; 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.