19D1095036 CLIA NUMBER - CHRITUS TRINITY CLINIC

Laboratory Demographics

  • CLIA Code: 19D1095036
  • Facility Name: CHRITUS TRINITY CLINIC
  • Facility Address: 7045 YOUREE DRIVE
    SHREVEPORT, LA
    ZIP 71105
  • Facility Phone: 318 681-6890
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARIEL P. GOELDEN
  • NPI Number: 1720237787
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D1095036
LAB Type Physician Office
Facility Name CHRITUS TRINITY CLINIC
Street 7045 YOUREE DRIVE
City SHREVEPORT
State LA
ZIP 71105
Phone 318 681-6890
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Physician Office
Lab Director ARIEL P. GOELDEN

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