19D2101839 CLIA NUMBER - CHENEVERT FAMILY CARE CLINIC

Laboratory Demographics

CLIA Number: 19D2101839

Facility Name: CHENEVERT FAMILY CARE CLINIC

Facility Address:
501 FRONT STREET
CHENEYVILLE, LA
ZIP 71325
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Facility Phone Number: 318 279-2300

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1811381072

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2101839
LAB Type	Rural Health Clinic
Facility Name	CHENEVERT FAMILY CARE CLINIC
Street	501 FRONT STREET
City	CHENEYVILLE
State	LA
ZIP	71325
Phone	318 279-2300
CertificateType	4
CertificateEffectiveDate	9/11/2023
CertificateExpirationDate	9/10/2025
FacilityType	Waiver

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