19D0990599 CLIA NUMBER - MOSS BLUFF MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 19D0990599
  • Facility Name: MOSS BLUFF MEDICAL CLINIC
  • Facility Address: 217 SAM HOUSTON JONES PARKWAY
    LAKE CHARLES, LA
    ZIP 70611
  • Facility Phone: 337 217-1000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANDRA D. BRUNO, MD
  • NPI Number: 1295868024
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D0990599
LAB Type Physician Office
Facility Name MOSS BLUFF MEDICAL CLINIC
Street 217 SAM HOUSTON JONES PARKWAY
City LAKE CHARLES
State LA
ZIP 70611
Phone 337 217-1000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2025
Certificate Expiration Date 8/27/2027
Facility Type Physician Office
Lab Director SANDRA D. BRUNO, MD

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