19D0878988 CLIA NUMBER - WALLACE LASER & SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 19D0878988
  • Facility Name: WALLACE LASER & SURGERY CENTER
  • Facility Address: 4100 PARLIAMENT DRIVE
    ALEXANDRIA, LA
    ZIP 71303
  • Facility Phone: 318 487-8342
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: R BRUCE WALLACE, III
  • NPI Number: 1184697930
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D0878988
LAB Type Ambulatory Surgery Center
Facility Name WALLACE LASER & SURGERY CENTER
Street 4100 PARLIAMENT DRIVE
City ALEXANDRIA
State LA
ZIP 71303
Phone 318 487-8342
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Ambulatory Surgery Center
Lab Director R BRUCE WALLACE, III

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This page was last updated on: 6/4/2025