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19D2201901 CLIA NUMBER - JENA BAND OF CHOCTAW INDIANS HEALTH DEPARTMENT

Laboratory Demographics

CLIA Number: 19D2201901

Facility Name: JENA BAND OF CHOCTAW INDIANS HEALTH DEPARTMENT

Facility Address:
1018 CHATA YAKNI STREET
TROUT, LA
ZIP 71371
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Facility Phone Number: 318 992-2763

Facility Type: Other - TRIBAL HEALTH

Certificate Type: Waiver
NPI Number: 1942751201

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 19D2201901
LAB Type Other - TRIBAL HEALTH
Facility Name JENA BAND OF CHOCTAW INDIANS HEALTH DEPARTMENT
Street 1018 CHATA YAKNI STREET
City TROUT
State LA
ZIP 71371
Phone 318 992-2763
CertificateType 4
CertificateEffectiveDate 11/24/2022
CertificateExpirationDate 11/23/2024
FacilityType Waiver

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