19D2041689 CLIA NUMBER - GARY M AGENA, MD

Laboratory Demographics

  • CLIA Code: 19D2041689
  • Facility Name: GARY M AGENA, MD
  • Facility Address: 393 HIGHWAY 21, SUITE 525
    MADISONVILLE, LA
    ZIP 70447
  • Facility Phone: 985 845-7121
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GARY M. AGENA
  • NPI Number: 1295768406
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 19D2041689
LAB Type Physician Office
Facility Name GARY M AGENA, MD
Street 393 HIGHWAY 21, SUITE 525
City MADISONVILLE
State LA
ZIP 70447
Phone 985 845-7121
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/29/2024
Certificate Expiration Date 5/28/2026
Facility Type Physician Office
Lab Director GARY M. AGENA

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