19D2033306 CLIA NUMBER - FAMILY CARE CLINIC

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Laboratory Demographics

CLIA Number: 19D2033306

Facility Name: FAMILY CARE CLINIC

Facility Address:
107 LELA ST
MANGHAM, LA
ZIP 71259
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Facility Phone Number: (318) 248-4100

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1023399888

Taxonomy: 261QP2300X - Clinic/Center

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

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This page was last updated on: 5/11/2023