19D1014531 CLIA NUMBER - VITALOGY, INC

Laboratory Demographics

  • CLIA Code: 19D1014531
  • Facility Name: VITALOGY, INC
  • Facility Address: 207 WEST THOMAS STREET
    HAMMOND, LA
    ZIP 70401
  • Facility Phone: 985 542-6007
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: JACKIE B. WILLIAMS
  • NPI Number: 1568991255
  • Taxonomy: 261QC1800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D1014531
LAB Type Mobile Laboratory
Facility Name VITALOGY, INC
Street 207 WEST THOMAS STREET
City HAMMOND
State LA
ZIP 70401
Phone 985 542-6007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2025
Certificate Expiration Date 7/8/2027
Facility Type Mobile Laboratory
Lab Director JACKIE B. WILLIAMS

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