19D2113862 CLIA NUMBER - SLMA COMPREHENSIVE HEALTHCARE CLINIC

Laboratory Demographics

CLIA Number: 19D2113862

Facility Name: SLMA COMPREHENSIVE HEALTHCARE CLINIC

Facility Address:
605 ENTERPRISE DRIVE, SUITE B
HOUMA, LA
ZIP 70360
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Facility Phone Number: 985 850-1039

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1699218131

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	19D2113862
LAB Type	Physician Office
Facility Name	SLMA COMPREHENSIVE HEALTHCARE CLINIC
Street	605 ENTERPRISE DRIVE, SUITE B
City	HOUMA
State	LA
ZIP	70360
Phone	985 850-1039
CertificateType	4
CertificateEffectiveDate	9/9/2023
CertificateExpirationDate	9/8/2025
FacilityType	Waiver

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