Provider Demographics
NPI:1518619691
Name:TRULAB DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:TRULAB DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:NICHOLES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:985-474-2114
Mailing Address - Street 1:178 BAKER RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:LA
Mailing Address - Zip Code:70443-4742
Mailing Address - Country:US
Mailing Address - Phone:985-474-2114
Mailing Address - Fax:985-247-2254
Practice Address - Street 1:178 BAKER RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:LA
Practice Address - Zip Code:70443-4742
Practice Address - Country:US
Practice Address - Phone:985-474-2114
Practice Address - Fax:985-247-2254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No291U00000XLaboratoriesClinical Medical Laboratory