19D0714850 CLIA NUMBER - CHILDREN'S HOSPITAL MEDICAL PRACTICE-SLIDELL

Laboratory Demographics

  • CLIA Code: 19D0714850
  • Facility Name: CHILDREN'S HOSPITAL MEDICAL PRACTICE-SLIDELL
  • Facility Address: 3020 GAUSE BOULEVARD E
    SLIDELL, LA
    ZIP 70461
  • Facility Phone: 985 726-0800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW STARK
  • NPI Number: 1790226967
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 19D0714850
LAB Type Physician Office
Facility Name CHILDREN'S HOSPITAL MEDICAL PRACTICE-SLIDELL
Street 3020 GAUSE BOULEVARD E
City SLIDELL
State LA
ZIP 70461
Phone 985 726-0800
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 MATTHEW STARK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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