19D0946314 CLIA NUMBER - WYCHE T COLEMAN MD APMC

Laboratory Demographics

  • CLIA Code: 19D0946314
  • Facility Name: WYCHE T COLEMAN MD APMC
  • Facility Address: 1633 MARVEL STREET
    COUSHATTA, LA
    ZIP 71019
  • Facility Phone: 318 932-9980
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSICA E. SMITH
  • NPI Number: 1710984513
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D0946314
LAB Type Physician Office
Facility Name WYCHE T COLEMAN MD APMC
Street 1633 MARVEL STREET
City COUSHATTA
State LA
ZIP 71019
Phone 318 932-9980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2025
Certificate Expiration Date 5/22/2027
Facility Type Physician Office
Lab Director JESSICA E. SMITH

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