19D2064386 CLIA NUMBER - ARK-LA-TEX SPINE

Laboratory Demographics

  • CLIA Code: 19D2064386
  • Facility Name: ARK-LA-TEX SPINE
  • Facility Address: 8660 FERN AVE SUITE 105
    SHREVEPORT, LA
    ZIP 71105
  • Facility Phone: 318 841-9999
  • Facility Type: Community Clinic
  • Facility Type: Certificate of Compliance
  • Lab Director: JANIS J. GULICK
  • NPI Number: 1245710920
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 19D2064386
LAB Type Community Clinic
Facility Name ARK-LA-TEX SPINE
Street 8660 FERN AVE SUITE 105
City SHREVEPORT
State LA
ZIP 71105
Phone 318 841-9999
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Community Clinic
Lab Director JANIS J. GULICK

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