19D2138947 CLIA NUMBER - ILES MEDICAL TESTING, LLC

Laboratory Demographics

  • CLIA Code: 19D2138947
  • Facility Name: ILES MEDICAL TESTING, LLC
  • Facility Address: 3437 DEREK DR
    LAKE CHARLES, LA
    ZIP 70607
  • Facility Phone: 337 562-0835
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: DOROTHY M. ILES
  • NPI Number: 1669984183
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 19D2138947
LAB Type Independent
Facility Name ILES MEDICAL TESTING, LLC
Street 3437 DEREK DR
City LAKE CHARLES
State LA
ZIP 70607
Phone 337 562-0835
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Independent
Lab Director DOROTHY M. ILES

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