19D2172087 CLIA NUMBER - STRAWBERRY PATCH PEDIATRICS & FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 19D2172087
  • Facility Name: STRAWBERRY PATCH PEDIATRICS & FAMILY MEDICINE
  • Facility Address: 1054 SW RAILROAD AVE
    PONCHATOULA, LA
    ZIP 70454
  • Facility Phone: 855 869-9898
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: LAURA L. DRAKE
  • NPI Number: 1861088098
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2172087
LAB Type Rural Health Clinic
Facility Name STRAWBERRY PATCH PEDIATRICS & FAMILY MEDICINE
Street 1054 SW RAILROAD AVE
City PONCHATOULA
State LA
ZIP 70454
Phone 855 869-9898
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Rural Health Clinic
Lab Director LAURA L. DRAKE

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