19D2074475 CLIA NUMBER - BATON ROUGE VASCULAR ACCESS, LLC

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Laboratory Demographics

CLIA Number: 19D2074475

Facility Name: BATON ROUGE VASCULAR ACCESS, LLC

Facility Address:
505 EAST AIRPORT ROAD
BATON ROUGE, LA
ZIP 70809
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Facility Phone Number: 225 769-2572

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1023542339

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2074475
LAB Type	Physician Office
Facility Name	BATON ROUGE VASCULAR ACCESS, LLC
Street	505 EAST AIRPORT ROAD
City	BATON ROUGE
State	LA
ZIP	70809
Phone	225 769-2572
CertificateType	4
CertificateEffectiveDate	3/11/2024
CertificateExpirationDate	3/10/2026
FacilityType	Waiver

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