19D0723902 CLIA NUMBER - ORTEGO HEALTHCARE, LLC

Laboratory Demographics

CLIA Number: 19D0723902

Facility Name: ORTEGO HEALTHCARE, LLC

Facility Address:
2949 SOUTH UNION STREET
OPELOUSAS, LA
ZIP 70570
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Facility Phone Number: 337 948-9606

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1750931945

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D0723902
LAB Type	Physician Office
Facility Name	ORTEGO HEALTHCARE, LLC
Street	2949 SOUTH UNION STREET
City	OPELOUSAS
State	LA
ZIP	70570
Phone	337 948-9606
CertificateType	4
CertificateEffectiveDate	3/25/2024
CertificateExpirationDate	3/24/2026
FacilityType	Waiver

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