19D1105955 CLIA NUMBER - BOMBINA MD PEDIATRICS

Laboratory Demographics

  • CLIA Code: 19D1105955
  • Facility Name: BOMBINA MD PEDIATRICS
  • Facility Address: 2924 KNIGHT ST, STE 350
    SHREVEPORT, LA
    ZIP 71105
  • Facility Phone: 318 946-8183
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SUYAH M. LOUD
  • NPI Number: 1427490937
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D1105955
LAB Type Physician Office
Facility Name BOMBINA MD PEDIATRICS
Street 2924 KNIGHT ST, STE 350
City SHREVEPORT
State LA
ZIP 71105
Phone 318 946-8183
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/1/2025
Certificate Expiration Date 9/30/2027
Facility Type Physician Office
Lab Director SUYAH M. LOUD

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