19D2328998 CLIA NUMBER - IMPERIAL HEALTH, COUMADIN CLINIC

Laboratory Demographics

  • CLIA Code: 19D2328998
  • Facility Name: IMPERIAL HEALTH, COUMADIN CLINIC
  • Facility Address: 501 DR MICHAEL DEBAKEY DRIVE, 4TH FLOOR
    LAKE CHARLES, LA
    ZIP 70601
  • Facility Phone: 337 312-8354
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAKE LEBEAU
  • NPI Number: 1619449725
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2328998
LAB Type Physician Office
Facility Name IMPERIAL HEALTH, COUMADIN CLINIC
Street 501 DR MICHAEL DEBAKEY DRIVE, 4TH FLOOR
City LAKE CHARLES
State LA
ZIP 70601
Phone 337 312-8354
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Physician Office
Lab Director JAKE LEBEAU

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