Provider Demographics
NPI:1740463207
Name:EUNICE MEDICAL LABORATORY INC
Entity type:Organization
Organization Name:EUNICE MEDICAL LABORATORY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBONNE
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:337-457-5562
Mailing Address - Street 1:450 MOOSA BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-3610
Mailing Address - Country:US
Mailing Address - Phone:337-457-5562
Mailing Address - Fax:337-550-7141
Practice Address - Street 1:450 MOOSA BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-3610
Practice Address - Country:US
Practice Address - Phone:337-457-5562
Practice Address - Fax:337-550-7141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA19D1075897291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory