19D2091243 CLIA NUMBER - PHUONG NGUYEN, MD, LLC

Laboratory Demographics

  • CLIA Code: 19D2091243
  • Facility Name: PHUONG NGUYEN, MD, LLC
  • Facility Address: 1111 MEDICAL CENTER BLVD STE 570 SOUTH
    MARRERO, LA
    ZIP 70072
  • Facility Phone: 504 349-6735
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHUONG NGUYEN
  • NPI Number: 1356431761
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 19D2091243
LAB Type Physician Office
Facility Name PHUONG NGUYEN, MD, LLC
Street 1111 MEDICAL CENTER BLVD STE 570 SOUTH
City MARRERO
State LA
ZIP 70072
Phone 504 349-6735
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Physician Office
Lab Director PHUONG NGUYEN

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