Leesville Diagnostic Center LP

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

21485 Issued in LA

Legal business name

LEESVILLE DIAGNOSTIC CENTER LP

Practice address

506 S 6TH St
Ste C
Leesville, LA 71446-4442

Phone

(337) 239-2992

Fax

(337) 392-8543

NPI assigned

May 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. David Lewis Miller

Title

Senior Vice President

Phone

(877) 892-9813

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992708499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 S 6TH ST",
            "address_2": "STE C",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464442",
            "telephone_number": "337-239-2992",
            "fax_number": "337-392-8543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 S 6TH ST",
            "address_2": "STE C",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464442",
            "telephone_number": "337-239-2992",
            "fax_number": "337-392-8543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEESVILLE DIAGNOSTIC CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "877-892-9813",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "LA",
            "license": "21485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Leesville, LA
• Providers in Leesville, 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 Aug 22, 2020; 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.