Audubon Fertility Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

19D2010657 Issued in LA

Legal business name

AUDUBON FERTILITY LABORATORY

Practice address

4321 Magnolia St
New Orleans, LA 70115-6227

Phone

(504) 891-1390

Fax

(504) 891-1391

NPI assigned

Jul 11, 2013

Organization subpart

No

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

Authorized official

Name

Paul Ronald Clisham, MD

Title

Lab Director and Owner

Phone

(504) 891-1390

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373500800000",
    "number": "1750722245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 MAGNOLIA ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701156227",
            "telephone_number": "504-891-1390",
            "fax_number": "504-891-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 MAGNOLIA ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701156227",
            "telephone_number": "504-891-1390",
            "fax_number": "504-891-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDUBON FERTILITY LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-07-11",
        "status": "A",
        "authorized_official_last_name": "CLISHAM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "LAB DIRECTOR AND OWNER",
        "authorized_official_telephone_number": "504-891-1390",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "LA",
            "license": "19D2010657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audibel Hearing Healthcare
• Gail Audrict
• Audubon Dermatology, LLC
• Audubon Fertility and Reproductive Medicine
• Audubon Fertility and Reproductive Medicine. L.L.C.
• Audubon Fertility, LLC
• Audubon Health Specialty, L.L.C.
• Audubon Labs LLC
• Audubon Retirement Village, Inc.
• Augillard Dental Group, LLC

• Clinical Medical Laboratory in New Orleans, LA
• Providers in New Orleans, 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 Jul 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.