19D2139975 CLIA NUMBER - MARKSVILLE FAMILY CLINIC

Laboratory Demographics

CLIA Number: 19D2139975

Facility Name: MARKSVILLE FAMILY CLINIC

Facility Address:
457 WEST WADDIL STREET, SUITE A
MARKSVILLE, LA
ZIP 71351
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Facility Phone Number: 800 462-0742

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1487183612

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2139975
LAB Type	Rural Health Clinic
Facility Name	MARKSVILLE FAMILY CLINIC
Street	457 WEST WADDIL STREET, SUITE A
City	MARKSVILLE
State	LA
ZIP	71351
Phone	800 462-0742
CertificateType	4
CertificateEffectiveDate	11/13/2023
CertificateExpirationDate	11/12/2025
FacilityType	Waiver

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