19D2145120 CLIA NUMBER - SPINE INNOVATIONS, LLC

Laboratory Demographics

  • CLIA Code: 19D2145120
  • Facility Name: SPINE INNOVATIONS, LLC
  • Facility Address: 29301 N DIXIE RANCH RD
    LACOMBE, LA
    ZIP 70445
  • Facility Phone: 985 871-4114
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DONALD D DIETZE
  • NPI Number: 1366973935
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 19D2145120
LAB Type Physician Office
Facility Name SPINE INNOVATIONS, LLC
Street 29301 N DIXIE RANCH RD
City LACOMBE
State LA
ZIP 70445
Phone 985 871-4114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director DONALD D DIETZE

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