19D1059640 CLIA NUMBER - GENESIS BEHAVIORAL HOSPITAL

Laboratory Demographics

  • CLIA Code: 19D1059640
  • Facility Name: GENESIS BEHAVIORAL HOSPITAL
  • Facility Address: 606 LATIOLAIS ROAD
    BREAUX BRIDGE, LA
    ZIP 70517
  • Facility Phone: 337 237-4673
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: CONSTANCE AMY
  • NPI Number: 1023119989
  • Taxonomy: 283Q00000X - Psychiatric Hospital

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CLIA Record

Field Name Field Value
CLIA Number 19D1059640
LAB Type Hospital
Facility Name GENESIS BEHAVIORAL HOSPITAL
Street 606 LATIOLAIS ROAD
City BREAUX BRIDGE
State LA
ZIP 70517
Phone 337 237-4673
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Hospital
Lab Director CONSTANCE AMY

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