19D2311251 CLIA NUMBER - PHYSICIAN PRACTICE PARTNERS TERREBONNE GENERAL MOBILE CARE CLINIC

Laboratory Demographics

  • CLIA Code: 19D2311251
  • Facility Name: PHYSICIAN PRACTICE PARTNERS TERREBONNE GENERAL MOBILE CARE CLINIC
  • Facility Address: 8166 MAIN ST
    HOUMA, LA
    ZIP 70360
  • Facility Phone: 985 850-6208
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: KIRBIE CHAISSON
  • NPI Number: 1477712156
  • Taxonomy: 247100000X - Radiologic Technologist

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CLIA Record

Field Name Field Value
CLIA Number 19D2311251
LAB Type Mobile Laboratory
Facility Name PHYSICIAN PRACTICE PARTNERS TERREBONNE GENERAL MOBILE CARE CLINIC
Street 8166 MAIN ST
City HOUMA
State LA
ZIP 70360
Phone 985 850-6208
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Mobile Laboratory
Lab Director KIRBIE CHAISSON

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