19D2035282 CLIA NUMBER - COUSHATTA FAMILY MEDICAL CENTER

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Laboratory Demographics

CLIA Number: 19D2035282

Facility Name: COUSHATTA FAMILY MEDICAL CENTER

Facility Address:
287 PANTHER TRAIL DRIVE
KINDER, LA
ZIP 70648
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Facility Phone Number: 337 738-4180

Facility Type: Other - EMPLOYER SPONSORED HEALTH

Certificate Type: Waiver

NPI Number: 1184912321

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	19D2035282
LAB Type	Other - EMPLOYER SPONSORED HEALTH
Facility Name	COUSHATTA FAMILY MEDICAL CENTER
Street	287 PANTHER TRAIL DRIVE
City	KINDER
State	LA
ZIP	70648
Phone	337 738-4180
CertificateType	4
CertificateEffectiveDate	1/13/2024
CertificateExpirationDate	1/12/2026
FacilityType	Waiver

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