19D0981190 CLIA NUMBER - IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY

Laboratory Demographics

  • CLIA Code: 19D0981190
  • Facility Name: IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
  • Facility Address: 4105 KIRKMAN ST
    LAKE CHARLES, LA
    ZIP 70607
  • Facility Phone: 337 475-3100
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: TANYA MCGEE
  • NPI Number: 1457822751
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D0981190
LAB Type Other
Facility Name IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
Street 4105 KIRKMAN ST
City LAKE CHARLES
State LA
ZIP 70607
Phone 337 475-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Other
Lab Director TANYA MCGEE

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