19D2213030 CLIA NUMBER - FLEUR-DE-LIS WHOLE HEALTHCARE LLC

Laboratory Demographics

CLIA Number: 19D2213030

Facility Name: FLEUR-DE-LIS WHOLE HEALTHCARE LLC

Facility Address:
1615 201 ST CHARLES AVE, STE 2500
NEW ORLEANS, LA
ZIP 70170
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Facility Phone Number: 504 321-7404

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1336759836

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	19D2213030
LAB Type	Physician Office
Facility Name	FLEUR-DE-LIS WHOLE HEALTHCARE LLC
Street	1615 201 ST CHARLES AVE, STE 2500
City	NEW ORLEANS
State	LA
ZIP	70170
Phone	504 321-7404
CertificateType	4
CertificateEffectiveDate	2/9/2023
CertificateExpirationDate	2/8/2025
FacilityType	Waiver

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