19D0715218 CLIA NUMBER - LUBBOS MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 19D0715218

Facility Name: LUBBOS MEDICAL CLINIC

Facility Address:
500 SOUTH SIXTH STREET
LEESVILLE, LA
ZIP 71446
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Facility Phone Number: 337 239-7227

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1922146844

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	19D0715218
LAB Type	Physician Office
Facility Name	LUBBOS MEDICAL CLINIC
Street	500 SOUTH SIXTH STREET
City	LEESVILLE
State	LA
ZIP	71446
Phone	337 239-7227
CertificateType	4
CertificateEffectiveDate	2/23/2023
CertificateExpirationDate	2/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024