19D1070018 CLIA NUMBER - JOSEPHINE M FUTRELL,MD,PHD DERMATOLOGY AND DERMATOLOGIC SURGERY

Laboratory Demographics

  • CLIA Code: 19D1070018
  • Facility Name: JOSEPHINE M FUTRELL,MD,PHD DERMATOLOGY AND DERMATOLOGIC SURGERY
  • Facility Address: 2300 HOSPITAL DRIVE, SUITE 400
    BOSSIER CITY, LA
    ZIP 71112
  • Facility Phone: 318 212-7800
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOSEPHINE M. FUTRELL,MD
  • NPI Number: 1609846500
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 19D1070018
LAB Type Physician Office
Facility Name JOSEPHINE M FUTRELL,MD,PHD DERMATOLOGY AND DERMATOLOGIC SURGERY
Street 2300 HOSPITAL DRIVE, SUITE 400
City BOSSIER CITY
State LA
ZIP 71112
Phone 318 212-7800
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/19/2025
Certificate Expiration Date 6/18/2027
Facility Type Physician Office
Lab Director JOSEPHINE M. FUTRELL,MD

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