19D1052209 CLIA NUMBER - CHILDRENS HOSPITAL OUT PATIENT CENTER OF BATON ROUGE

Laboratory Demographics

  • CLIA Code: 19D1052209
  • Facility Name: CHILDRENS HOSPITAL OUT PATIENT CENTER OF BATON ROUGE
  • Facility Address: 9001 SUMMA AVENUE, SUITE 342
    BATON ROUGE, LA
    ZIP 70809
  • Facility Phone: 225 216-3047
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW STARK
  • NPI Number: 1124541438
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D1052209
LAB Type Physician Office
Facility Name CHILDRENS HOSPITAL OUT PATIENT CENTER OF BATON ROUGE
Street 9001 SUMMA AVENUE, SUITE 342
City BATON ROUGE
State LA
ZIP 70809
Phone 225 216-3047
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Physician Office
Lab Director MATTHEW STARK

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