19D2253603 CLIA NUMBER - BOSTON PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 19D2253603
  • Facility Name: BOSTON PRIMARY CARE, LLC
  • Facility Address: 18448 MAGNOLIA BRIDGE RODA, SUITE A
    GREENWELL SPRINGS, LA
    ZIP 70739
  • Facility Phone: 225 256-0063
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM J. BOSTON
  • NPI Number: 1891454328
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 19D2253603
LAB Type Physician Office
Facility Name BOSTON PRIMARY CARE, LLC
Street 18448 MAGNOLIA BRIDGE RODA, SUITE A
City GREENWELL SPRINGS
State LA
ZIP 70739
Phone 225 256-0063
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Physician Office
Lab Director WILLIAM J. BOSTON

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