19D1014969 CLIA NUMBER - OUTPATIENT MEDICAL SERVICES

Laboratory Demographics

CLIA Number: 19D1014969

Facility Name: OUTPATIENT MEDICAL SERVICES

Facility Address:
3916 LA HIGHWAY ONE
RACELAND, LA
ZIP 70394
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Facility Phone Number: 985 537-0048

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1144344748

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	19D1014969
LAB Type	Physician Office
Facility Name	OUTPATIENT MEDICAL SERVICES
Street	3916 LA HIGHWAY ONE
City	RACELAND
State	LA
ZIP	70394
Phone	985 537-0048
CertificateType	4
CertificateEffectiveDate	7/21/2023
CertificateExpirationDate	7/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024