19D2267914 CLIA NUMBER - WK ELITE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 19D2267914
  • Facility Name: WK ELITE INTERNAL MEDICINE
  • Facility Address: 2551 ALBERT BICKNELL DR STE 220
    SHREVEPORT, LA
    ZIP 71103
  • Facility Phone: 318 212-5980
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJ GANDHI
  • NPI Number: 1245800192
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2267914
LAB Type Physician Office
Facility Name WK ELITE INTERNAL MEDICINE
Street 2551 ALBERT BICKNELL DR STE 220
City SHREVEPORT
State LA
ZIP 71103
Phone 318 212-5980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Physician Office
Lab Director RAJ GANDHI

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