19D1069665 CLIA NUMBER - PHILLIPS FAMILY MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 19D1069665
  • Facility Name: PHILLIPS FAMILY MEDICINE CLINIC
  • Facility Address: 1117 HOMER RD
    MINDEN, LA
    ZIP 71055
  • Facility Phone: 318 382-9401
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: G SCOTT PHILLIPS
  • NPI Number: 1104987536
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 19D1069665
LAB Type Physician Office
Facility Name PHILLIPS FAMILY MEDICINE CLINIC
Street 1117 HOMER RD
City MINDEN
State LA
ZIP 71055
Phone 318 382-9401
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Physician Office
Lab Director G SCOTT PHILLIPS

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