Organization · NPI-2

Eagle Labs 1

Clinical Medical Laboratory · Hattiesburg, MS

NPI number1710367982
StatusActive
Last updated in NPPESMar 4, 2022

Details

NPI
1710367982
Entity type
Organization (NPI-2)
Legal business name
Eagle Labs 1
Organization subpart
No
Enumeration date
Jun 3, 2015
Certification date
Mar 4, 2022
Last updated
Mar 4, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
291U00000X Clinical Medical Laboratory––Yes

Practice location

4 Willow Pointe
Suite 3
Hattiesburg, MS 39402

Phone 601-909-6282

Mailing address

4 Willow Pointe
Suite 3
Hattiesburg, MS 39402

Phone 601-909-6274 · Fax 601-909-6287

Authorized official

Jory E Scott
Owner
6019096274

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