19D0677073 CLIA NUMBER - BOOKER T WASHINGTON SKILLED NURSING & REHAB

Laboratory Demographics

  • CLIA Code: 19D0677073
  • Facility Name: BOOKER T WASHINGTON SKILLED NURSING & REHAB
  • Facility Address: 7605 LINE AVENUE
    SHREVEPORT, LA
    ZIP 71106
  • Facility Phone: 318 219-2608
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KOURTNEY BROWNLEE
  • NPI Number: 1861873770
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 19D0677073
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BOOKER T WASHINGTON SKILLED NURSING & REHAB
Street 7605 LINE AVENUE
City SHREVEPORT
State LA
ZIP 71106
Phone 318 219-2608
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 KOURTNEY BROWNLEE

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