19D1039132 CLIA NUMBER - JEFFERSON AMBULATORY SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 19D1039132
  • Facility Name: JEFFERSON AMBULATORY SURGERY CENTER LLC
  • Facility Address: 2701 LAKE VILLA DRIVE
    METAIRIE, LA
    ZIP 70002
  • Facility Phone: 504 832-2115
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SUSAN MCPHERSON RN
  • NPI Number: 1669586376
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D1039132
LAB Type Ambulatory Surgery Center
Facility Name JEFFERSON AMBULATORY SURGERY CENTER LLC
Street 2701 LAKE VILLA DRIVE
City METAIRIE
State LA
ZIP 70002
Phone 504 832-2115
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Ambulatory Surgery Center
Lab Director SUSAN MCPHERSON RN

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