19D0674487 CLIA NUMBER - MANOHAR R MANCHANDIA MD

Laboratory Demographics

  • CLIA Code: 19D0674487
  • Facility Name: MANOHAR R MANCHANDIA MD
  • Facility Address: 2706 SHED ROAD
    BOSSIER CITY, LA
    ZIP 71111
  • Facility Phone: 318 747-5272
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MANOHAR R. MANCHANDIA MD
  • NPI Number: 1023086873
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 19D0674487
LAB Type Physician Office
Facility Name MANOHAR R MANCHANDIA MD
Street 2706 SHED ROAD
City BOSSIER CITY
State LA
ZIP 71111
Phone 318 747-5272
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 Physician Office
Lab Director MANOHAR R. MANCHANDIA MD

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