19D2304467 CLIA NUMBER - ELITE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 19D2304467
  • Facility Name: ELITE PRIMARY CARE
  • Facility Address: 5600 CYPRESS STREET, SUITE 4
    WEST MONROE, LA
    ZIP 71291
  • Facility Phone: 318 536-0388
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANA G. REITZAMMER
  • NPI Number: 1588446900
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 19D2304467
LAB Type Physician Office
Facility Name ELITE PRIMARY CARE
Street 5600 CYPRESS STREET, SUITE 4
City WEST MONROE
State LA
ZIP 71291
Phone 318 536-0388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Physician Office
Lab Director DANA G. REITZAMMER

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