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19D1094683 CLIA NUMBER - NORTHSHORE AMBULATORY SURGERY CTR LLC

Laboratory Demographics

CLIA Number: 19D1094683

Facility Name: NORTHSHORE AMBULATORY SURGERY CTR LLC

Facility Address:
17174 SOUTH I 12 SERVICE ROAD
HAMMOND, LA
ZIP 70403
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Facility Phone Number: 985 375-1120

Facility Type: Ambulance

Certificate Type: Waiver
NPI Number: 1861907776

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 19D1094683
LAB Type Ambulance
Facility Name NORTHSHORE AMBULATORY SURGERY CTR LLC
Street 17174 SOUTH I 12 SERVICE ROAD
City HAMMOND
State LA
ZIP 70403
Phone 985 375-1120
CertificateType 4
CertificateEffectiveDate 1/23/2023
CertificateExpirationDate 1/22/2025
FacilityType Waiver

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