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19D2007912 CLIA NUMBER - EVANGELINE PRIMARY CARE, LLC

Laboratory Demographics

CLIA Number: 19D2007912

Facility Name: EVANGELINE PRIMARY CARE, LLC

Facility Address:
503 JACK MILLER RD, STE B
VILLE PLATTE, LA
ZIP 70586
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Facility Phone Number: 337 363-7036

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1487970299

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 19D2007912
LAB Type Physician Office
Facility Name EVANGELINE PRIMARY CARE, LLC
Street 503 JACK MILLER RD, STE B
City VILLE PLATTE
State LA
ZIP 70586
Phone 337 363-7036
CertificateType 4
CertificateEffectiveDate 5/28/2022
CertificateExpirationDate 5/27/2024
FacilityType Waiver

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