19D2267881 CLIA NUMBER - HOMETOWN HEALTHCARE, LLC

Laboratory Demographics

CLIA Number: 19D2267881

Facility Name: HOMETOWN HEALTHCARE, LLC

Facility Address:
5630 HIGHWAY 28 EAST
PINEVILLE, LA
ZIP 71360
Get Directions

Facility Phone Number: 318 704-0025

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1073098232

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	19D2267881
LAB Type	Physician Office
Facility Name	HOMETOWN HEALTHCARE, LLC
Street	5630 HIGHWAY 28 EAST
City	PINEVILLE
State	LA
ZIP	71360
Phone	318 704-0025
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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