19D0997955 CLIA NUMBER - WK BOSSIER OB-GYN

Laboratory Demographics

  • CLIA Code: 19D0997955
  • Facility Name: WK BOSSIER OB-GYN
  • Facility Address: 2449 HOSPITAL DRIVE, SUITE 260
    BOSSIER CITY, LA
    ZIP 71111
  • Facility Phone: 318 212-7840
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: L G. BLANTON, MD
  • NPI Number: 1326080995
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 19D0997955
LAB Type Physician Office
Facility Name WK BOSSIER OB-GYN
Street 2449 HOSPITAL DRIVE, SUITE 260
City BOSSIER CITY
State LA
ZIP 71111
Phone 318 212-7840
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/1/2024
Certificate Expiration Date 3/31/2026
Facility Type Physician Office
Lab Director L G. BLANTON, MD

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