19D2033306 CLIA NUMBER - FAMILY CARE CLINIC

Laboratory Demographics

  • CLIA Code: 19D2033306
  • Facility Name: FAMILY CARE CLINIC
  • Facility Address: 107 LELA ST
    MANGHAM, LA
    ZIP 71259
  • Facility Phone: 318 248-4100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERRI L. KLICK
  • NPI Number: 1023399888
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2033306
LAB Type Physician Office
Facility Name FAMILY CARE CLINIC
Street 107 LELA ST
City MANGHAM
State LA
ZIP 71259
Phone 318 248-4100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
Certificate Expiration Date 11/28/2025
Facility Type Physician Office
Lab Director TERRI L. KLICK

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This page was last updated on: 6/4/2025