19D0463188 CLIA NUMBER - GREEN MEADOW HAVEN

Laboratory Demographics

  • CLIA Code: 19D0463188
  • Facility Name: GREEN MEADOW HAVEN
  • Facility Address: 1110 RINGGOLD AVE
    COUSHATTA, LA
    ZIP 71019
  • Facility Phone: 318 932-5006
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JUANITA RABURN RN
  • NPI Number: 1912121716
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 19D0463188
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GREEN MEADOW HAVEN
Street 1110 RINGGOLD AVE
City COUSHATTA
State LA
ZIP 71019
Phone 318 932-5006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JUANITA RABURN RN

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