Provider Demographics
NPI:1780272351
Name:ON CALL LAB DRAW LLC
Entity type:Organization
Organization Name:ON CALL LAB DRAW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHLEBOTOMY TECHNICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEENA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPI (ACA)
Authorized Official - Phone:337-485-1220
Mailing Address - Street 1:1040 ANN ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:LA
Mailing Address - Zip Code:70669-3802
Mailing Address - Country:US
Mailing Address - Phone:337-485-1220
Mailing Address - Fax:337-476-2018
Practice Address - Street 1:303 S HUNTINGTON ST
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-3335
Practice Address - Country:US
Practice Address - Phone:337-485-1220
Practice Address - Fax:337-476-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty