19D1041950 CLIA NUMBER - ACADIA PARISH POLICE JURY COMMUNITY CLINIC

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Laboratory Demographics

CLIA Number: 19D1041950

Facility Name: ACADIA PARISH POLICE JURY COMMUNITY CLINIC

Facility Address:
200 FROG FESTIVAL DRIVE
RAYNE, LA
ZIP 70578
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Facility Phone Number: 337 334-2153

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1578684494

Taxonomy: 261QP0905X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D1041950
LAB Type	Community Clinic
Facility Name	ACADIA PARISH POLICE JURY COMMUNITY CLINIC
Street	200 FROG FESTIVAL DRIVE
City	RAYNE
State	LA
ZIP	70578
Phone	337 334-2153
CertificateType	4
CertificateEffectiveDate	6/16/2023
CertificateExpirationDate	6/15/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024