19D2079398 CLIA NUMBER - RAVEN CORPORATION PRIMARY HEALTH CARE

Laboratory Demographics

  • CLIA Code: 19D2079398
  • Facility Name: RAVEN CORPORATION PRIMARY HEALTH CARE
  • Facility Address: 8080 CROWDER BLVD, SUITE E
    NEW ORLEANS, LA
    ZIP 70127
  • Facility Phone: 504 493-5132
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT J. JEMISON
  • NPI Number: 1861825929
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 19D2079398
LAB Type Physician Office
Facility Name RAVEN CORPORATION PRIMARY HEALTH CARE
Street 8080 CROWDER BLVD, SUITE E
City NEW ORLEANS
State LA
ZIP 70127
Phone 504 493-5132
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2025
Certificate Expiration Date 7/29/2027
Facility Type Physician Office
Lab Director ROBERT J. JEMISON

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