19D1000391 CLIA NUMBER - TILAK K MALLIK, MD, FACE, LLC

Laboratory Demographics

  • CLIA Code: 19D1000391
  • Facility Name: TILAK K MALLIK, MD, FACE, LLC
  • Facility Address: 1111 MEDICAL CENTER BLVD, SUITE S113
    MARRERO, LA
    ZIP 70072
  • Facility Phone: 504 349-6520
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TILAK K. MALLIK, MD
  • NPI Number: 1437160959
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D1000391
LAB Type Physician Office
Facility Name TILAK K MALLIK, MD, FACE, LLC
Street 1111 MEDICAL CENTER BLVD, SUITE S113
City MARRERO
State LA
ZIP 70072
Phone 504 349-6520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2024
Certificate Expiration Date 6/16/2026
Facility Type Physician Office
Lab Director TILAK K. MALLIK, MD

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