19D2316318 CLIA NUMBER - MIND AND BODY CARE, LLC

Laboratory Demographics

  • CLIA Code: 19D2316318
  • Facility Name: MIND AND BODY CARE, LLC
  • Facility Address: 1428 GAUSE BLVD, STE 107
    SLIDELL, LA
    ZIP 70458
  • Facility Phone: 985 285-6843
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: TINA MALONSON
  • NPI Number: 1902684608
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 19D2316318
LAB Type Community Clinic
Facility Name MIND AND BODY CARE, LLC
Street 1428 GAUSE BLVD, STE 107
City SLIDELL
State LA
ZIP 70458
Phone 985 285-6843
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2025
Certificate Expiration Date 1/1/2027
Facility Type Community Clinic
Lab Director TINA MALONSON

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