19D2232638 CLIA NUMBER - CASTING CARE CLINIC

Laboratory Demographics

  • CLIA Code: 19D2232638
  • Facility Name: CASTING CARE CLINIC
  • Facility Address: 7840 JEWELLA AVE
    SHREVEPORT, LA
    ZIP 71108
  • Facility Phone: 318 401-1432
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: LASONYA JONES
  • NPI Number: 1295492999
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 19D2232638
LAB Type Practitioner Other
Facility Name CASTING CARE CLINIC
Street 7840 JEWELLA AVE
City SHREVEPORT
State LA
ZIP 71108
Phone 318 401-1432
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Practitioner Other
Lab Director LASONYA JONES

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