19D2156022 CLIA NUMBER - LANDMARK MEDICAL OF LOUISANA, PROFESSIONAL CORP

Laboratory Demographics

CLIA Number: 19D2156022

Facility Name: LANDMARK MEDICAL OF LOUISANA, PROFESSIONAL CORP

Facility Address:
1 GALLERIA BLVD, SUITE 1420
METAIRIE, LA
ZIP 70001
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Facility Phone Number: 833 362-6703

Facility Type: Other - MOBILE PHYSICIAN GROUP

Certificate Type: Waiver

NPI Number: 1801391743

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	19D2156022
LAB Type	Other - MOBILE PHYSICIAN GROUP
Facility Name	LANDMARK MEDICAL OF LOUISANA, PROFESSIONAL CORP
Street	1 GALLERIA BLVD, SUITE 1420
City	METAIRIE
State	LA
ZIP	70001
Phone	833 362-6703
CertificateType	4
CertificateEffectiveDate	10/9/2022
CertificateExpirationDate	10/8/2024
FacilityType	Waiver

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