19D2134761 CLIA NUMBER - ALEXANDRIA PEDIATRIC GROUP CENLA CHILDRENS

Laboratory Demographics

  • CLIA Code: 19D2134761
  • Facility Name: ALEXANDRIA PEDIATRIC GROUP CENLA CHILDRENS
  • Facility Address: 3916 JACKSON ST
    ALEXANDRIA, LA
    ZIP 71303
  • Facility Phone: 318 445-2223
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANIL DANIVAS
  • NPI Number: 1699097360
  • Taxonomy: 207ZP0102X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 19D2134761
LAB Type Physician Office
Facility Name ALEXANDRIA PEDIATRIC GROUP CENLA CHILDRENS
Street 3916 JACKSON ST
City ALEXANDRIA
State LA
ZIP 71303
Phone 318 445-2223
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2025
Certificate Expiration Date 8/8/2027
Facility Type Physician Office
Lab Director ANIL DANIVAS

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