19D2316630 CLIA NUMBER - NEW ROADS FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 19D2316630
  • Facility Name: NEW ROADS FAMILY PRACTICE LLC
  • Facility Address: 213 W MAIN STREET
    NEW ROADS, LA
    ZIP 70760
  • Facility Phone: 225 242-9162
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: ANGELA D. KENNERLY
  • NPI Number: 1366204182
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2316630
LAB Type Mobile Laboratory
Facility Name NEW ROADS FAMILY PRACTICE LLC
Street 213 W MAIN STREET
City NEW ROADS
State LA
ZIP 70760
Phone 225 242-9162
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2025
Certificate Expiration Date 1/8/2027
Facility Type Mobile Laboratory
Lab Director ANGELA D. KENNERLY

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