19D1055958 CLIA NUMBER - SUREACCESS MD LLC

Laboratory Demographics

  • CLIA Code: 19D1055958
  • Facility Name: SUREACCESS MD LLC
  • Facility Address: 8525 LINE AVE SUITE A
    SHREVEPORT, LA
    ZIP 71106
  • Facility Phone: 318 300-4926
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD MICHAEL
  • NPI Number: 1821034679
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D1055958
LAB Type Physician Office
Facility Name SUREACCESS MD LLC
Street 8525 LINE AVE SUITE A
City SHREVEPORT
State LA
ZIP 71106
Phone 318 300-4926
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Physician Office
Lab Director RICHARD MICHAEL

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