19D2109046 CLIA NUMBER - BASILE RURAL HEALTH CLINIC

Laboratory Demographics

CLIA Number: 19D2109046

Facility Name: BASILE RURAL HEALTH CLINIC

Facility Address:
1431 FUSILIER AVENUE
BASILE, LA
ZIP 70515
Get Directions

Facility Phone Number: 337 432-0200

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609234012

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2109046
LAB Type	Physician Office
Facility Name	BASILE RURAL HEALTH CLINIC
Street	1431 FUSILIER AVENUE
City	BASILE
State	LA
ZIP	70515
Phone	337 432-0200
CertificateType	4
CertificateEffectiveDate	2/18/2024
CertificateExpirationDate	2/17/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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