19D1076446 CLIA NUMBER - LA SALLE DETENTION FACILITY - IHSC

Laboratory Demographics

  • CLIA Code: 19D1076446
  • Facility Name: LA SALLE DETENTION FACILITY - IHSC
  • Facility Address: 830 PINEHILL ROAD
    JENA, LA
    ZIP 71342
  • Facility Phone: 318 992-7612
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: ROGER D. BALLARD
  • NPI Number: 1649369315
  • Taxonomy: 302F00000X - Exclusive Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 19D1076446
LAB Type Prison
Facility Name LA SALLE DETENTION FACILITY - IHSC
Street 830 PINEHILL ROAD
City JENA
State LA
ZIP 71342
Phone 318 992-7612
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2024
Certificate Expiration Date 8/25/2026
Facility Type Prison
Lab Director ROGER D. BALLARD

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