19D2050559 CLIA NUMBER - SOUTHERNCARE, INC - BATON ROUGE OFFICE

Laboratory Demographics

  • CLIA Code: 19D2050559
  • Facility Name: SOUTHERNCARE, INC - BATON ROUGE OFFICE
  • Facility Address: 17316 AIRLINE HIGHWAY, SUITE P
    PRAIRIEVILLE, LA
    ZIP 70769
  • Facility Phone: 704 662-0416
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: KELLY SANDERS
  • NPI Number: 1851338339
  • Taxonomy: 163WH1000X - Registered Nurse

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CLIA Record

Field Name Field Value
CLIA Number 19D2050559
LAB Type Hospice
Facility Name SOUTHERNCARE, INC - BATON ROUGE OFFICE
Street 17316 AIRLINE HIGHWAY, SUITE P
City PRAIRIEVILLE
State LA
ZIP 70769
Phone 704 662-0416
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2024
Certificate Expiration Date 11/29/2026
Facility Type Hospice
Lab Director KELLY SANDERS

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