Provider Demographics
NPI:1588088587
Name:AKRIVIS LABORATORIES LLC
Entity type:Organization
Organization Name:AKRIVIS LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:THIGPEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-414-2832
Mailing Address - Street 1:1615 RASTON DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-6233
Mailing Address - Country:US
Mailing Address - Phone:888-414-2832
Mailing Address - Fax:
Practice Address - Street 1:1402 S MAGNOLIA ST
Practice Address - Street 2:UNIT H
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5020
Practice Address - Country:US
Practice Address - Phone:888-414-2832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA19D2072678291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory