19D2035110 CLIA NUMBER - SURREY STREET COMMUNITY HEALTH CENTER SITE 1

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Laboratory Demographics

CLIA Number: 19D2035110

Facility Name: SURREY STREET COMMUNITY HEALTH CENTER SITE 1

Facility Address:
1004 SURREY STREET
LAFAYETTE, LA
ZIP 70501
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Facility Phone Number: 337 365-4945

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1568731602

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2035110
LAB Type	Federally Qualified Health Center
Facility Name	SURREY STREET COMMUNITY HEALTH CENTER SITE 1
Street	1004 SURREY STREET
City	LAFAYETTE
State	LA
ZIP	70501
Phone	337 365-4945
CertificateType	3
CertificateEffectiveDate	1/11/2024
CertificateExpirationDate	1/10/2026
FacilityType	PPMP

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