19D0962679 CLIA NUMBER - VERSAILLES HEALTH CLINIC

Laboratory Demographics

CLIA Number: 19D0962679

Facility Name: VERSAILLES HEALTH CLINIC

Facility Address:
4657A ALCEE FORTIER BLVD
NEW ORLEANS, LA
ZIP 70129
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Facility Phone Number: 504 244-2808

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1194998500

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	19D0962679
LAB Type	Physician Office
Facility Name	VERSAILLES HEALTH CLINIC
Street	4657A ALCEE FORTIER BLVD
City	NEW ORLEANS
State	LA
ZIP	70129
Phone	504 244-2808
CertificateType	4
CertificateEffectiveDate	7/12/2023
CertificateExpirationDate	7/11/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024