19D1028077 CLIA NUMBER - CHILDREN'S HOSPITAL PEDIATRICS ORMOND

Laboratory Demographics

  • CLIA Code: 19D1028077
  • Facility Name: CHILDREN'S HOSPITAL PEDIATRICS ORMOND
  • Facility Address: 141 ORMOND CENTER COURT
    DESTREHAN, LA
    ZIP 70047
  • Facility Phone: 985 764-7337
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW STARK
  • NPI Number: 1689739971
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 19D1028077
LAB Type Physician Office
Facility Name CHILDREN'S HOSPITAL PEDIATRICS ORMOND
Street 141 ORMOND CENTER COURT
City DESTREHAN
State LA
ZIP 70047
Phone 985 764-7337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Physician Office
Lab Director MATTHEW STARK

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