19D1069061 CLIA NUMBER - LAKE IMAGING CENTER PERKINS PLAZA IMAGING CENTER

Laboratory Demographics

  • CLIA Code: 19D1069061
  • Facility Name: LAKE IMAGING CENTER PERKINS PLAZA IMAGING CENTER
  • Facility Address: 7135 PERKINS ROAD
    BATON ROUGE, LA
    ZIP 70808
  • Facility Phone: 225 765-8600
  • Facility Type: Other - IMAGING SERVICES
  • Facility Type: Waiver
  • Lab Director: MICHAEL T. JACKSON
  • NPI Number: 1336193028
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D1069061
LAB Type Other - IMAGING SERVICES
Facility Name LAKE IMAGING CENTER PERKINS PLAZA IMAGING CENTER
Street 7135 PERKINS ROAD
City BATON ROUGE
State LA
ZIP 70808
Phone 225 765-8600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2025
Certificate Expiration Date 5/28/2027
Facility Type Other - IMAGING SERVICES
Lab Director MICHAEL T. JACKSON

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