OrganizationActive
Immunolase LLC
NPI 1427416171 · Clinical & Laboratory Immunology (Allergy & Immunology) Physician · Harvey, LA
Provider details
- NPI number
- 1427416171
- Entity type
- Organization
- Primary specialty
- Clinical & Laboratory Immunology (Allergy & Immunology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Brennen Lark, Member/Ceo(504) 372-6250
- License
- 19D2105974 (LA)
Specialties & taxonomies
- Clinical & Laboratory Immunology (Allergy & Immunology) PhysicianPrimary207KI0005XLicense 19D2105974 (LA)
Allopathic & Osteopathic Physicians
Practice location
1901 Manhattan Blvd Bldg D
Harvey, LA 70058-3583
Phone: (504) 372-6250
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1414
Sagamore Beach, MA 02562-1414
Registry dates
- Enumerated
- 2016-02-09
- Last updated
- 2018-03-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.