19D2208770 CLIA NUMBER - IMPACT CHARTER SCHOOL EDUCATION EXPLOSION

Laboratory Demographics

  • CLIA Code: 19D2208770
  • Facility Name: IMPACT CHARTER SCHOOL EDUCATION EXPLOSION
  • Facility Address: 4815 LAVEY LANE
    BAKER, LA
    ZIP 70714
  • Facility Phone: 225 308-9565
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: CHAKESHA SCOTT
  • NPI Number: 1609245489
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 19D2208770
LAB Type School/Student Health Service
Facility Name IMPACT CHARTER SCHOOL EDUCATION EXPLOSION
Street 4815 LAVEY LANE
City BAKER
State LA
ZIP 70714
Phone 225 308-9565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2025
Certificate Expiration Date 1/7/2027
Facility Type School/Student Health Service
Lab Director CHAKESHA SCOTT

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