19D2251987 CLIA NUMBER - INNOVATIVE MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 19D2251987
  • Facility Name: INNOVATIVE MEDICAL CLINIC
  • Facility Address: 985 ROBERT BLVD, STE 103
    SLIDELL, LA
    ZIP 70458
  • Facility Phone: 985 643-5242
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN VERNON BARTON
  • NPI Number: 1538275771
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2251987
LAB Type Physician Office
Facility Name INNOVATIVE MEDICAL CLINIC
Street 985 ROBERT BLVD, STE 103
City SLIDELL
State LA
ZIP 70458
Phone 985 643-5242
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Physician Office
Lab Director JOHN VERNON BARTON

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