19D0877747 CLIA NUMBER - WESTSIDE HABILITATION CENTER INC

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CLIA Record

Field Name Field Value
CLIA Number 19D0877747
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name WESTSIDE HABILITATION CENTER INC
Street 3071 NORTH BOLTON AVE
City ALEXANDRIA
State LA
ZIP 71303
Phone 318 445-1551
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2025
Certificate Expiration Date 10/6/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director C BOLTON

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