19D2262464 CLIA NUMBER - INTERNAL MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 19D2262464
  • Facility Name: INTERNAL MEDICINE CLINIC
  • Facility Address: 2770 3RD AVE, SUITE 320
    LAKE CHARLES, LA
    ZIP 70601
  • Facility Phone: 337 494-6800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK LAFURIA
  • NPI Number: 1669494654
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2262464
LAB Type Physician Office
Facility Name INTERNAL MEDICINE CLINIC
Street 2770 3RD AVE, SUITE 320
City LAKE CHARLES
State LA
ZIP 70601
Phone 337 494-6800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2024
Certificate Expiration Date 6/13/2026
Facility Type Physician Office
Lab Director MARK LAFURIA

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