Provider Demographics
NPI:1629446968
Name:ROSEMOND SCHOOL OF PHLEBOTOMY CLINICAL LABORATORY-RESEARCH & TESTING,
Entity Type:Organization
Organization Name:ROSEMOND SCHOOL OF PHLEBOTOMY CLINICAL LABORATORY-RESEARCH & TESTING,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ORA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CML
Authorized Official - Phone:225-644-2422
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:BRITTANY
Mailing Address - State:LA
Mailing Address - Zip Code:70718-0355
Mailing Address - Country:US
Mailing Address - Phone:225-644-2422
Mailing Address - Fax:225-644-2428
Practice Address - Street 1:1425 S PURPERA
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737
Practice Address - Country:US
Practice Address - Phone:225-644-2422
Practice Address - Fax:225-644-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACLP-L02556-LAB291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
LACLP-L02556-LABOtherLSBME
LAS5T3L6L9OtherNHA
LA26-900329928OtherOSHA