19D2084331 CLIA NUMBER - PEDIATRIC HEALTH CHOICE PRESCRIBED PEDIATRIC EXTENDED CARE, INC

Laboratory Demographics

  • CLIA Code: 19D2084331
  • Facility Name: PEDIATRIC HEALTH CHOICE PRESCRIBED PEDIATRIC EXTENDED CARE, INC
  • Facility Address: 2644 NORTH CAUSEWAY BLVD SUITE 100
    METAIRIE, LA
    ZIP 70002
  • Facility Phone: 504 704-5647
  • Facility Type: Other - PED DAY HEALTH FACILITY
  • Facility Type: Waiver
  • Lab Director: DEBORAH E. FRAZE
  • NPI Number: 1003943135
  • Taxonomy: 1223P0221X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 19D2084331
LAB Type Other - PED DAY HEALTH FACILITY
Facility Name PEDIATRIC HEALTH CHOICE PRESCRIBED PEDIATRIC EXTENDED CARE, INC
Street 2644 NORTH CAUSEWAY BLVD SUITE 100
City METAIRIE
State LA
ZIP 70002
Phone 504 704-5647
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Other - PED DAY HEALTH FACILITY
Lab Director DEBORAH E. FRAZE

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This page was last updated on: 3/20/2025