19D2326414 CLIA NUMBER - DPDNP LLC DBA VITALIS HEALTH AND WELLNESS

Laboratory Demographics

  • CLIA Code: 19D2326414
  • Facility Name: DPDNP LLC DBA VITALIS HEALTH AND WELLNESS
  • Facility Address: 1264 AVENUE DU CHATEAU
    COVINGTON, LA
    ZIP 70433
  • Facility Phone: 504 914-7889
  • Facility Type: Other - NURSE PRACTITIONER MOBILE
  • Facility Type: Waiver
  • Lab Director: DUSTIN DENICOLA
  • NPI Number: 1225638737
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 19D2326414
LAB Type Other - NURSE PRACTITIONER MOBILE
Facility Name DPDNP LLC DBA VITALIS HEALTH AND WELLNESS
Street 1264 AVENUE DU CHATEAU
City COVINGTON
State LA
ZIP 70433
Phone 504 914-7889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2025
Certificate Expiration Date 7/1/2027
Facility Type Other - NURSE PRACTITIONER MOBILE
Lab Director DUSTIN DENICOLA

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