19D2087064 CLIA NUMBER - ODYSSEY HOUSE LOUISIANA, INC

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Laboratory Demographics

CLIA Number: 19D2087064

Facility Name: ODYSSEY HOUSE LOUISIANA, INC

Facility Address:
1125 N TONTI STREET
NEW ORLEANS, LA
ZIP 70119
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Facility Phone Number: 504 913-6776

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1588065569

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	19D2087064
LAB Type	Federally Qualified Health Center
Facility Name	ODYSSEY HOUSE LOUISIANA, INC
Street	1125 N TONTI STREET
City	NEW ORLEANS
State	LA
ZIP	70119
Phone	504 913-6776
CertificateType	4
CertificateEffectiveDate	11/17/2022
CertificateExpirationDate	11/16/2024
FacilityType	Waiver

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