19D0859594 CLIA NUMBER - PONTCHARTRAIN HEALTH CARE CENTRE

Laboratory Demographics

  • CLIA Code: 19D0859594
  • Facility Name: PONTCHARTRAIN HEALTH CARE CENTRE
  • Facility Address: 1401 HIGHWAY 190
    MANDEVILLE, LA
    ZIP 70470
  • Facility Phone: 985 626-8581
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DALE COONEY
  • NPI Number: 1821213505
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 19D0859594
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PONTCHARTRAIN HEALTH CARE CENTRE
Street 1401 HIGHWAY 190
City MANDEVILLE
State LA
ZIP 70470
Phone 985 626-8581
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 DALE COONEY

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