19D2007929 CLIA NUMBER - THOMAS P MELANCON, MD

Laboratory Demographics

  • CLIA Code: 19D2007929
  • Facility Name: THOMAS P MELANCON, MD
  • Facility Address: 4700 WICHERS DR, SUITE 204
    MARRERO, LA
    ZIP 70072
  • Facility Phone: 504 392-7999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIM M. MARCEL
  • NPI Number: 1811989197
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2007929
LAB Type Physician Office
Facility Name THOMAS P MELANCON, MD
Street 4700 WICHERS DR, SUITE 204
City MARRERO
State LA
ZIP 70072
Phone 504 392-7999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/2024
Certificate Expiration Date 5/27/2026
Facility Type Physician Office
Lab Director KIM M. MARCEL

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