19D2076194 CLIA NUMBER - NEW HAVEN FAMILY MEDICINE, INC

Home > CLIA Lookup > 19D2076194

Laboratory Demographics

CLIA Number: 19D2076194

Facility Name: NEW HAVEN FAMILY MEDICINE, INC

Facility Address:
333 DR MICHAEL DEBAKEY DRIVE, SUITE 120
LAKE CHARLES, LA
ZIP 70601
Get Directions

Facility Phone Number: 337 493-8480

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1174773881

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	19D2076194
LAB Type	Physician Office
Facility Name	NEW HAVEN FAMILY MEDICINE, INC
Street	333 DR MICHAEL DEBAKEY DRIVE, SUITE 120
City	LAKE CHARLES
State	LA
ZIP	70601
Phone	337 493-8480
CertificateType	4
CertificateEffectiveDate	2/27/2024
CertificateExpirationDate	2/26/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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