19D2307170 CLIA NUMBER - OCCUPATIONAL & INTEGRATIVE MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 19D2307170
  • Facility Name: OCCUPATIONAL & INTEGRATIVE MEDICINE, LLC
  • Facility Address: 221 SOUTHPARK ROAD, BUILDING B
    LAFAYETTE, LA
    ZIP 70508
  • Facility Phone: 337 534-0420
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: DONNA B. WILSON
  • NPI Number: 1477398956
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2307170
LAB Type Hospital
Facility Name OCCUPATIONAL & INTEGRATIVE MEDICINE, LLC
Street 221 SOUTHPARK ROAD, BUILDING B
City LAFAYETTE
State LA
ZIP 70508
Phone 337 534-0420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Hospital
Lab Director DONNA B. WILSON

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