19D2142135 CLIA NUMBER - PINE PRAIRIE COMMUNITY CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 19D2142135
  • Facility Name: PINE PRAIRIE COMMUNITY CLINIC, LLC
  • Facility Address: 1121 WALNUT STREET
    PINE PRAIRIE, LA
    ZIP 70576
  • Facility Phone: 337 224-5337
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: CARMEN N. ROLLINS
  • NPI Number: 1366402364
  • Taxonomy: 183500000X - Pharmacist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 19D2142135
LAB Type Rural Health Clinic
Facility Name PINE PRAIRIE COMMUNITY CLINIC, LLC
Street 1121 WALNUT STREET
City PINE PRAIRIE
State LA
ZIP 70576
Phone 337 224-5337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Rural Health Clinic
Lab Director CARMEN N. ROLLINS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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