19D2066625 CLIA NUMBER - CRESCENT CITY HEADACHE AND NEUROLOGY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 19D2066625
  • Facility Name: CRESCENT CITY HEADACHE AND NEUROLOGY CENTER, LLC
  • Facility Address: 2116 PAKENHAM DRIVE
    CHALMETTE, LA
    ZIP 70043
  • Facility Phone: 504 301-1468
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CAROL REDILLAS
  • NPI Number: 1518409663
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 19D2066625
LAB Type Physician Office
Facility Name CRESCENT CITY HEADACHE AND NEUROLOGY CENTER, LLC
Street 2116 PAKENHAM DRIVE
City CHALMETTE
State LA
ZIP 70043
Phone 504 301-1468
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Physician Office
Lab Director CAROL REDILLAS

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