19D1037741 CLIA NUMBER - MAGNOLIA PEDIATRICS

Laboratory Demographics

  • CLIA Code: 19D1037741
  • Facility Name: MAGNOLIA PEDIATRICS
  • Facility Address: 17038 COMMERCE CENTRE DRIVE
    PRAIRIEVILLE, LA
    ZIP 70769
  • Facility Phone: (225) 744-4484
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMATHA K. GULINO
  • NPI Number: 1477611556
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 19D1037741
LAB Type Physician Office
Facility Name MAGNOLIA PEDIATRICS
Street 17038 COMMERCE CENTRE DRIVE
City PRAIRIEVILLE
State LA
ZIP 70769
Phone 2257444484
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2025
Certificate Expiration Date 3/2/2027
Facility Type Physician Office
Lab Director SAMATHA K. GULINO

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This page was last updated on: 5/18/2026