19D2149641 CLIA NUMBER - SOUTHSTAR URGENT CARE-IBERIA #2 LA #4

Laboratory Demographics

CLIA Number: 19D2149641

Facility Name: SOUTHSTAR URGENT CARE-IBERIA #2 LA #4

Facility Address:
1050 E ADMIRAL DOYLE DR, STE A
NEW IBERIA, LA
ZIP 70560
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Facility Phone Number: 337 465-2151

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1275002685

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2149641
LAB Type	Physician Office
Facility Name	SOUTHSTAR URGENT CARE-IBERIA #2 LA #4
Street	1050 E ADMIRAL DOYLE DR, STE A
City	NEW IBERIA
State	LA
ZIP	70560
Phone	337 465-2151
CertificateType	4
CertificateEffectiveDate	6/7/2022
CertificateExpirationDate	6/6/2024
FacilityType	Waiver

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