19D0674063 CLIA NUMBER - HIGHLAND PLACE REHAB AND NURSING CENTER IRVING PLACE ASSOCIATES, LP

Laboratory Demographics

  • CLIA Code: 19D0674063
  • Facility Name: HIGHLAND PLACE REHAB AND NURSING CENTER IRVING PLACE ASSOCIATES, LP
  • Facility Address: 1736 IRVING PLACE
    SHREVEPORT, LA
    ZIP 71101
  • Facility Phone: 318 221-1983
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: VICKI L. OTT
  • NPI Number: 1912062043
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 19D0674063
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HIGHLAND PLACE REHAB AND NURSING CENTER IRVING PLACE ASSOCIATES, LP
Street 1736 IRVING PLACE
City SHREVEPORT
State LA
ZIP 71101
Phone 318 221-1983
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 VICKI L. OTT

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