Provider Demographics
NPI:1194822544
Name:L&B LABORATORIES, INC
Entity Type:Organization
Organization Name:L&B LABORATORIES, INC
Other - Org Name:DAVID R WYATT
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:WYATT
Authorized Official - Suffix:
Authorized Official - Credentials:BCO
Authorized Official - Phone:504-522-2354
Mailing Address - Street 1:2800 VETERANS MEMORIAL BLVD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-522-2354
Mailing Address - Fax:504-596-6733
Practice Address - Street 1:2800 VETERANS MEMORIAL BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-522-2354
Practice Address - Fax:504-596-6733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1972851Medicaid
LA0440550002Medicare NSC