Provider Demographics
NPI:1356687842
Name:VIVERE-NEW ORLEANS FERTILITY LABORATORY, LLC
Entity Type:Organization
Organization Name:VIVERE-NEW ORLEANS FERTILITY LABORATORY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-550-4913
Mailing Address - Street 1:720 COOL SPRINGS BLVD
Mailing Address - Street 2:STE. 520
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2626
Mailing Address - Country:US
Mailing Address - Phone:615-550-4900
Mailing Address - Fax:615-550-4901
Practice Address - Street 1:2701 NAPOLEON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6913
Practice Address - Country:US
Practice Address - Phone:504-564-7965
Practice Address - Fax:504-875-4788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-02
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA19D2074886OtherCLIA