19D2113527 CLIA NUMBER - IMPERIAL HEALTH, DR ANDRES GUILLERMO

Laboratory Demographics

  • CLIA Code: 19D2113527
  • Facility Name: IMPERIAL HEALTH, DR ANDRES GUILLERMO
  • Facility Address: 711 DR. MICHAEL DEBAKEY DRIVE
    LAKE CHARLES, LA
    ZIP 70601
  • Facility Phone: 337 312-8960
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDRES GUILLERMO
  • NPI Number: 1801270194
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2113527
LAB Type Physician Office
Facility Name IMPERIAL HEALTH, DR ANDRES GUILLERMO
Street 711 DR. MICHAEL DEBAKEY DRIVE
City LAKE CHARLES
State LA
ZIP 70601
Phone 337 312-8960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Physician Office
Lab Director ANDRES GUILLERMO

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