19D2328757 CLIA NUMBER - WILLOW TOTAL HEALTH

Laboratory Demographics

  • CLIA Code: 19D2328757
  • Facility Name: WILLOW TOTAL HEALTH
  • Facility Address: 4061 HIGHWAY 90 EAST SUITE 112
    BROUSSARD, LA
    ZIP 70518
  • Facility Phone: 337 761-0727
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHELBI J. MEYER
  • NPI Number: 1255131413
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 19D2328757
LAB Type Physician Office
Facility Name WILLOW TOTAL HEALTH
Street 4061 HIGHWAY 90 EAST SUITE 112
City BROUSSARD
State LA
ZIP 70518
Phone 337 761-0727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Physician Office
Lab Director SHELBI J. MEYER

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