19D2284751 CLIA NUMBER - MAYO BEHAVIORAL HEALTH SERVICES

Laboratory Demographics

CLIA Number: 19D2284751

Facility Name: MAYO BEHAVIORAL HEALTH SERVICES

Facility Address:
7612 PICARDY AVE, STE H
BATON ROUGE, LA
ZIP 70808
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Facility Phone Number: 225 254-0110

Facility Type: Other - SUBS/ALCOHOL ABUSE CNTR

Certificate Type: Waiver

NPI Number: 1043916513

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2284751
LAB Type	Other - SUBS/ALCOHOL ABUSE CNTR
Facility Name	MAYO BEHAVIORAL HEALTH SERVICES
Street	7612 PICARDY AVE, STE H
City	BATON ROUGE
State	LA
ZIP	70808
Phone	225 254-0110
CertificateType	4
CertificateEffectiveDate	6/28/2023
CertificateExpirationDate	6/27/2025
FacilityType	Waiver

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