19D2275131 CLIA NUMBER - NORTHSHORE PLASTIC SURGERY LLC

Laboratory Demographics

  • CLIA Code: 19D2275131
  • Facility Name: NORTHSHORE PLASTIC SURGERY LLC
  • Facility Address: 3401 EAST CAUSEWAY APPROACH
    MANDEVILLE, LA
    ZIP 70448
  • Facility Phone: 985 237-6050
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BENJAMIN J. BOUDREAUX
  • NPI Number: 1568690469
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 19D2275131
LAB Type Ambulatory Surgery Center
Facility Name NORTHSHORE PLASTIC SURGERY LLC
Street 3401 EAST CAUSEWAY APPROACH
City MANDEVILLE
State LA
ZIP 70448
Phone 985 237-6050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Ambulatory Surgery Center
Lab Director BENJAMIN J. BOUDREAUX

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