19D2170413 CLIA NUMBER - BAART PROGAMS LAPLACE BAYMARK HEALTH SERVICES OF LOUISIANA, INC

Laboratory Demographics

CLIA Number: 19D2170413

Facility Name: BAART PROGAMS LAPLACE BAYMARK HEALTH SERVICES OF LOUISIANA, INC

Facility Address:
128 WOODLAND DR
LAPLACE, LA
ZIP 70068
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Facility Phone Number: 985 651-3777

Facility Type: Other - NARCOTIC TREATMENT PROGRA

Certificate Type: Waiver

NPI Number: 1922654946

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2170413
LAB Type	Other - NARCOTIC TREATMENT PROGRA
Facility Name	BAART PROGAMS LAPLACE BAYMARK HEALTH SERVICES OF LOUISIANA, INC
Street	128 WOODLAND DR
City	LAPLACE
State	LA
ZIP	70068
Phone	985 651-3777
CertificateType	4
CertificateEffectiveDate	8/12/2023
CertificateExpirationDate	8/11/2025
FacilityType	Waiver

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