19D2057233 CLIA NUMBER - ADVANCED PRACTICE ASSOCIATES, LLC

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Laboratory Demographics

CLIA Number: 19D2057233

Facility Name: ADVANCED PRACTICE ASSOCIATES, LLC

Facility Address:
2107 HONOR STREET STE C
MONROE, LA
ZIP 71201
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Facility Phone Number: 318 450-6129

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1104181247

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2057233
LAB Type	Practitioner Other
Facility Name	ADVANCED PRACTICE ASSOCIATES, LLC
Street	2107 HONOR STREET STE C
City	MONROE
State	LA
ZIP	71201
Phone	318 450-6129
CertificateType	4
CertificateEffectiveDate	4/11/2023
CertificateExpirationDate	4/10/2025
FacilityType	Waiver

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