19D1029664 CLIA NUMBER - LIFE SOURCE SERVICES LLC

Laboratory Demographics

  • CLIA Code: 19D1029664
  • Facility Name: LIFE SOURCE SERVICES LLC
  • Facility Address: 11605 SOUTHFORK AVE, STE A
    BATON ROUGE, LA
    ZIP 70816
  • Facility Phone: 225 291-9421
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MICHELE BROWNING
  • NPI Number: 1356309199
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 19D1029664
LAB Type Hospice
Facility Name LIFE SOURCE SERVICES LLC
Street 11605 SOUTHFORK AVE, STE A
City BATON ROUGE
State LA
ZIP 70816
Phone 225 291-9421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Hospice
Lab Director MICHELE BROWNING

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