Provider Demographics
NPI:1982038261
Name:PERFORMANCE LAB'S LLC
Entity Type:Organization
Organization Name:PERFORMANCE LAB'S LLC
Other - Org Name:PERFORMANCE LAB'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:PFEFFERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-734-1927
Mailing Address - Street 1:50 EAST CT
Mailing Address - Street 2:UNIT 8
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-7798
Mailing Address - Country:US
Mailing Address - Phone:504-734-1927
Mailing Address - Fax:
Practice Address - Street 1:50 EAST CT
Practice Address - Street 2:UNIT 8
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-7798
Practice Address - Country:US
Practice Address - Phone:504-734-1927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory