Alexandria Pathology Laboratory, LLC
Organization Active NPI Anatomic Pathology & Clinical Pathology Physician · Alexandria, LA
NPI 1902887995 · NPPES record last updated Feb 10, 2010
Key facts
- NPI
- 1902887995
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- Legal business name
- ALEXANDRIA PATHOLOGY LABORATORY, LLC
- Practice address
- 3330 Masonic Dr
Laboratory
Alexandria, LA 71301-3841 - Phone
- (318) 443-0941
- Fax
- (318) 443-5734
- NPI assigned
- Nov 8, 2005
- Organization subpart
- No
Authorized official
- Name
- Dr. Sudha G Pillarisetti, M.D.
- Title
- Owner/Partner
- Phone
- (318) 443-0941
Practitioners 2
-
Sudha G Pillarisetti, M.D.
-
Irene G Ibanez-Manlapaz, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 19D2294114 | Pathology Laboratory, LLC -- Alexandria, the | Compliance | May 29, 2028 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician |
207ZP0102X | Yes | ||
| Clinical Medical Laboratory | 291U00000X | LA |
Addresses
Primary practice location
3330 Masonic Dr
Laboratory
Alexandria, LA 71301-3841
Mailing address
PO Box 12116
3510 Parliament CT.
Alexandria, LA 71315-2116
Phone (318) 443-0941
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1441996 | Medicaid | LA | |
| G0919 | Other | LA | BCBSLA (ANATOMIC) |
| 1189286 | Medicaid | LA | |
| CT0606 | Other | LA | PALMETTO GBA - RRMC |
| 11773 | Other | LA | BCBSLA (CLINICAL) |
| 1069922 | Other | LA | CIGNA |
Other names
- ROBERTS, PILLARISETTI & MANLAPAZ
Other providers in Alexandria, LA
- Alexandria Hospital, LLC
- Alexandria Neurosurgical Clinic Inc
- Alexandria Oral Surgery Associates LLP
- Alexandria Otolaryngology Associates
- Alexandria Pathology Laboratory, LLC
- Alexandria Pediatric Dentistry - a Partnership
- Alexandria Pediatric Gastro, Inc
- Alexandria Pediatrics, LLC
- Alexandria Primary Care Clinic
- Alexandria Rehabilitation , LLC
All providers in Alexandria, LA · Anatomic Pathology & Clinical Pathology Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.