19D2191917 CLIA NUMBER - PRIME OCCUPATIONAL MEDICINE

Laboratory Demographics

  • CLIA Code: 19D2191917
  • Facility Name: PRIME OCCUPATIONAL MEDICINE
  • Facility Address: 15475 AIRLINE HWY, BUILDING B
    BATON ROUGE, LA
    ZIP 70817
  • Facility Phone: 225 408-5902
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LUKE LEE
  • NPI Number: 1699237800
  • Taxonomy: 261QX0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2191917
LAB Type Physician Office
Facility Name PRIME OCCUPATIONAL MEDICINE
Street 15475 AIRLINE HWY, BUILDING B
City BATON ROUGE
State LA
ZIP 70817
Phone 225 408-5902
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Physician Office
Lab Director LUKE LEE

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