19D0457870 CLIA NUMBER - CHARLES SIMONSON MD

Laboratory Demographics

  • CLIA Code: 19D0457870
  • Facility Name: CHARLES SIMONSON MD
  • Facility Address: 1255 AVENUE D
    MARRERO, LA
    ZIP 70072
  • Facility Phone: 504 347-5435
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHARLES SIMONSON
  • NPI Number: 1376731588
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D0457870
LAB Type Physician Office
Facility Name CHARLES SIMONSON MD
Street 1255 AVENUE D
City MARRERO
State LA
ZIP 70072
Phone 504 347-5435
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director CHARLES SIMONSON

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This page was last updated on: 9/29/2025