19D2079406 CLIA NUMBER - OIL CENTER SURGICAL PLAZA, LLC

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Laboratory Demographics

CLIA Number: 19D2079406

Facility Name: OIL CENTER SURGICAL PLAZA, LLC

Facility Address:
1000 WEST PINHOOK ROAD, SUITE 204
LAFAYETTE, LA
ZIP 70503
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Facility Phone Number: 337 289-8214

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1437574191

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2079406
LAB Type	Ambulatory Surgery Center
Facility Name	OIL CENTER SURGICAL PLAZA, LLC
Street	1000 WEST PINHOOK ROAD, SUITE 204
City	LAFAYETTE
State	LA
ZIP	70503
Phone	337 289-8214
CertificateType	4
CertificateEffectiveDate	6/16/2022
CertificateExpirationDate	6/15/2024
FacilityType	Waiver

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