19D0670889 CLIA NUMBER - CAMELOT BROOKSIDE

Laboratory Demographics

  • CLIA Code: 19D0670889
  • Facility Name: CAMELOT BROOKSIDE
  • Facility Address: 3330 N FRONTAGE ROAD
    JENNINGS, LA
    ZIP 70546
  • Facility Phone: 337 824-2466
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ALISON B. DIETZ
  • NPI Number: 1689943078
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 19D0670889
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CAMELOT BROOKSIDE
Street 3330 N FRONTAGE ROAD
City JENNINGS
State LA
ZIP 70546
Phone 337 824-2466
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 ALISON B. DIETZ

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