Provider Demographics
NPI:1629718994
Name:WSECRETS LABORATORY SERVICES LLC
Entity Type:Organization
Organization Name:WSECRETS LABORATORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATESHA
Authorized Official - Middle Name:RHODES
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:985-859-9586
Mailing Address - Street 1:283 BUCCANEER RD
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:LA
Mailing Address - Zip Code:70359-4823
Mailing Address - Country:US
Mailing Address - Phone:985-859-9586
Mailing Address - Fax:985-873-5944
Practice Address - Street 1:283 BUCCANEER RD
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:LA
Practice Address - Zip Code:70359-4823
Practice Address - Country:US
Practice Address - Phone:985-859-9586
Practice Address - Fax:985-873-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty