19D1024859 CLIA NUMBER - LAKE VISTA PEDIATRICS KEITH J CAPONE, MD, LLC

Laboratory Demographics

  • CLIA Code: 19D1024859
  • Facility Name: LAKE VISTA PEDIATRICS KEITH J CAPONE, MD, LLC
  • Facility Address: 6517 SPANISH FORT BOULEVARD
    NEW ORLEANS, LA
    ZIP 70124
  • Facility Phone: 504 283-7306
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEITH J. CAPONE, MD
  • NPI Number: 1467523050
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 19D1024859
LAB Type Physician Office
Facility Name LAKE VISTA PEDIATRICS KEITH J CAPONE, MD, LLC
Street 6517 SPANISH FORT BOULEVARD
City NEW ORLEANS
State LA
ZIP 70124
Phone 504 283-7306
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director KEITH J. CAPONE, MD

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