19D2112505 CLIA NUMBER - CENTRAL IMAGING CENTER

Laboratory Demographics

  • CLIA Code: 19D2112505
  • Facility Name: CENTRAL IMAGING CENTER
  • Facility Address: 11424 SULLIVAN RD BLDG B, SUITE C ATTN MISTY METZ
    BATON ROUGE, LA
    ZIP 70818
  • Facility Phone: 225 261-7401
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: JIMMY QUEBEDEAUX
  • NPI Number: 1912954520
  • Taxonomy: 261QM1200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2112505
LAB Type Independent
Facility Name CENTRAL IMAGING CENTER
Street 11424 SULLIVAN RD BLDG B, SUITE C ATTN MISTY METZ
City BATON ROUGE
State LA
ZIP 70818
Phone 225 261-7401
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2024
Certificate Expiration Date 5/1/2026
Facility Type Independent
Lab Director JIMMY QUEBEDEAUX

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