19D0982790 CLIA NUMBER - FAMILY PRACTICE SOUTH

Laboratory Demographics

  • CLIA Code: 19D0982790
  • Facility Name: FAMILY PRACTICE SOUTH
  • Facility Address: 2508 BERT KOUNS, SUITE 102
    SHREVEPORT, LA
    ZIP 71118
  • Facility Phone: (318) 687-5277
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THANN D. VO
  • NPI Number: 1164443826
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D0982790
LAB Type Physician Office
Facility Name FAMILY PRACTICE SOUTH
Street 2508 BERT KOUNS, SUITE 102
City SHREVEPORT
State LA
ZIP 71118
Phone 3186875277
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Physician Office
Lab Director THANN D. VO

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This page was last updated on: 5/18/2026