19D2186513 CLIA NUMBER - BLENDED ROOTS WELLNES & CONSULTING

Laboratory Demographics

  • CLIA Code: 19D2186513
  • Facility Name: BLENDED ROOTS WELLNES & CONSULTING
  • Facility Address: 469 AUTUMN HAVEN CIRCLE
    LACOMBE, LA
    ZIP 70445
  • Facility Phone: 985 377-9094
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: ADJUAN G. EDGERSON
  • NPI Number: 1912522962
  • Taxonomy: 251J00000X - Nursing Care

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CLIA Record

Field Name Field Value
CLIA Number 19D2186513
LAB Type Independent
Facility Name BLENDED ROOTS WELLNES & CONSULTING
Street 469 AUTUMN HAVEN CIRCLE
City LACOMBE
State LA
ZIP 70445
Phone 985 377-9094
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2024
Certificate Expiration Date 6/17/2026
Facility Type Independent
Lab Director ADJUAN G. EDGERSON

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