19D1091843 CLIA NUMBER - IMPERIAL HEALTH URGENT CARE MOSS BLUFF

Laboratory Demographics

  • CLIA Code: 19D1091843
  • Facility Name: IMPERIAL HEALTH URGENT CARE MOSS BLUFF
  • Facility Address: 277 HWY 171 NORTH SUITE 10
    LAKE CHARLES, LA
    ZIP 70611
  • Facility Phone: (337) 217-7762
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TODD PEAVY
  • NPI Number: 1679718472
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D1091843
LAB Type Physician Office
Facility Name IMPERIAL HEALTH URGENT CARE MOSS BLUFF
Street 277 HWY 171 NORTH SUITE 10
City LAKE CHARLES
State LA
ZIP 70611
Phone 3372177762
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Physician Office
Lab Director TODD PEAVY

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This page was last updated on: 6/29/2026