19D1082908 CLIA NUMBER - ADVANCED MEDICAL MANAGEMENT

Laboratory Demographics

CLIA Number: 19D1082908

Facility Name: ADVANCED MEDICAL MANAGEMENT

Facility Address:
3440 DIVISION STREET, SUITE I
METAIRIE, LA
ZIP 70002
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Facility Phone Number: 601 916-4317

Facility Type: Other - CLINIC LAB

Certificate Type: Waiver

NPI Number: 1922488485

Taxonomy: 2086S0122X - Surgery
A surgeon who specializes in plastic and reconstructive surgery.

CLIA Record

Field Name	Field Value
CLIA Number	19D1082908
LAB Type	Other - CLINIC LAB
Facility Name	ADVANCED MEDICAL MANAGEMENT
Street	3440 DIVISION STREET, SUITE I
City	METAIRIE
State	LA
ZIP	70002
Phone	601 916-4317
CertificateType	4
CertificateEffectiveDate	10/25/2023
CertificateExpirationDate	10/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024