Provider Demographics
NPI:1851998520
Name:KW LAB & INSURANCE SERVICES, LLC
Entity Type:Organization
Organization Name:KW LAB & INSURANCE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:225-892-9494
Mailing Address - Street 1:3695 RIDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-4629
Mailing Address - Country:US
Mailing Address - Phone:225-819-3335
Mailing Address - Fax:800-212-2609
Practice Address - Street 1:11843 BRICKSOME AVE STE C
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-5310
Practice Address - Country:US
Practice Address - Phone:225-819-3335
Practice Address - Fax:800-212-2609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory