19D1024569 CLIA NUMBER - CADDO PARISH FIRE DISTRICK #1

Laboratory Demographics

  • CLIA Code: 19D1024569
  • Facility Name: CADDO PARISH FIRE DISTRICK #1
  • Facility Address: 7058 OLD MOORINGSPORT ROAD
    SHREVEPORT, LA
    ZIP 71107
  • Facility Phone: 318 929-3575
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: DAN J. COTTEN
  • NPI Number: 1518702182
  • Taxonomy: 261QP2400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D1024569
LAB Type Ambulance
Facility Name CADDO PARISH FIRE DISTRICK #1
Street 7058 OLD MOORINGSPORT ROAD
City SHREVEPORT
State LA
ZIP 71107
Phone 318 929-3575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Ambulance
Lab Director DAN J. COTTEN

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