19D2267867 CLIA NUMBER - PRESTIGE URGENT CARE, INC

Laboratory Demographics

CLIA Number: 19D2267867

Facility Name: PRESTIGE URGENT CARE, INC

Facility Address:
3775 YOUREE DRIVE
SHREVEPORT, LA
ZIP 71105
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Facility Phone Number: 318 562-3366

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1164150124

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2267867
LAB Type	Other - URGENT CARE
Facility Name	PRESTIGE URGENT CARE, INC
Street	3775 YOUREE DRIVE
City	SHREVEPORT
State	LA
ZIP	71105
Phone	318 562-3366
CertificateType	4
CertificateEffectiveDate	1/22/2024
CertificateExpirationDate	1/21/2026
FacilityType	Waiver

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