19D2193579 CLIA NUMBER - LOUISIANA FAMILY PRACTICE

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Laboratory Demographics

CLIA Number: 19D2193579

Facility Name: LOUISIANA FAMILY PRACTICE

Facility Address:
151 HILL STREET
EUNICE, LA
ZIP 70535
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Facility Phone Number: 337 457-8040

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003467440

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2193579
LAB Type	Physician Office
Facility Name	LOUISIANA FAMILY PRACTICE
Street	151 HILL STREET
City	EUNICE
State	LA
ZIP	70535
Phone	337 457-8040
CertificateType	4
CertificateEffectiveDate	9/23/2022
CertificateExpirationDate	9/22/2024
FacilityType	Waiver

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