19D2191719 CLIA NUMBER - ALLY MENTAL HEALTH, LLC

Laboratory Demographics

  • CLIA Code: 19D2191719
  • Facility Name: ALLY MENTAL HEALTH, LLC
  • Facility Address: 16270 AIRLINE HWY, SUITE D
    PRAIRIEVILLE, LA
    ZIP 70769
  • Facility Phone: 225 402-2299
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SHANTELL T. BURNS
  • NPI Number: 1205463254
  • Taxonomy: 261QM0801X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 19D2191719
LAB Type Practitioner Other
Facility Name ALLY MENTAL HEALTH, LLC
Street 16270 AIRLINE HWY, SUITE D
City PRAIRIEVILLE
State LA
ZIP 70769
Phone 225 402-2299
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2024
Certificate Expiration Date 8/30/2026
Facility Type Practitioner Other
Lab Director SHANTELL T. BURNS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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