19D1072269 CLIA NUMBER - WK RED RIVER INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 19D1072269
  • Facility Name: WK RED RIVER INTERNAL MEDICINE
  • Facility Address: 2300 HOSPITAL DRIVE SUITE 320
    BOSSIER CITY, LA
    ZIP 71111
  • Facility Phone: (318) 212-7848
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LESLIE SEWELL, MD
  • NPI Number: 1992023998
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D1072269
LAB Type Physician Office
Facility Name WK RED RIVER INTERNAL MEDICINE
Street 2300 HOSPITAL DRIVE SUITE 320
City BOSSIER CITY
State LA
ZIP 71111
Phone 3182127848
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2025
Certificate Expiration Date 8/12/2027
Facility Type Physician Office
Lab Director LESLIE SEWELL, MD

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This page was last updated on: 5/18/2026