19D2132985 CLIA NUMBER - MAXEM HEALTH URGENT CARE SLIDELL

Laboratory Demographics

CLIA Number: 19D2132985

Facility Name: MAXEM HEALTH URGENT CARE SLIDELL

Facility Address:
170 NORTH SHORE BLVD
SLIDELL, LA
ZIP 70460
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Facility Phone Number: 985 542-2299

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1619409158

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2132985
LAB Type	Other - URGENT CARE
Facility Name	MAXEM HEALTH URGENT CARE SLIDELL
Street	170 NORTH SHORE BLVD
City	SLIDELL
State	LA
ZIP	70460
Phone	985 542-2299
CertificateType	4
CertificateEffectiveDate	7/3/2023
CertificateExpirationDate	7/2/2025
FacilityType	Waiver

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