| Organization Name: | LAFAYETTE DIAGNOSTICS, INC. |
| NPI Number: | 1942539044 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | YERBOL KOSHIMBAYEV (PRESIDENT) |
| Mailing Address: | 1019 Kaliste Saloom Rd Suite # 711 Lafayette |
| State: | LA US |
| Postal Code: | 705084935 |
| Phone Number: | 3372144399 |
| Fax Number: | |
| NPI Enumeration Date: | 12/18/2009 |
| NPI Last Update Date: | 01/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |