19D0876012 CLIA NUMBER - DIVINITY HOME HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 19D0876012
  • Facility Name: DIVINITY HOME HEALTH SERVICES
  • Facility Address: 200 EAST 6TH STREET
    THIBODAUX, LA
    ZIP 70301
  • Facility Phone: 985 262-0445
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JESSICA ROLAND
  • NPI Number: 1801224084
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 19D0876012
LAB Type Home Health Agency
Facility Name DIVINITY HOME HEALTH SERVICES
Street 200 EAST 6TH STREET
City THIBODAUX
State LA
ZIP 70301
Phone 985 262-0445
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/7/2025
Certificate Expiration Date 9/6/2027
Facility Type Home Health Agency
Lab Director JESSICA ROLAND

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