19D1090069 CLIA NUMBER - BOBBY T ENSMINGER MD

Laboratory Demographics

  • CLIA Code: 19D1090069
  • Facility Name: BOBBY T ENSMINGER MD
  • Facility Address: 1200 CELEBRITY DRIVE, SUITE 1
    RUSTON, LA
    ZIP 71270
  • Facility Phone: 318 255-8271
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BOBBY T. ENSMINGER
  • NPI Number: 1508813742
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D1090069
LAB Type Physician Office
Facility Name BOBBY T ENSMINGER MD
Street 1200 CELEBRITY DRIVE, SUITE 1
City RUSTON
State LA
ZIP 71270
Phone 318 255-8271
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Physician Office
Lab Director BOBBY T. ENSMINGER

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