LAKE CHARLES VA CLINIC (3420) INSTITUTION (4)

Name	Value
NAME	LAKE CHARLES VA CLINIC
STATE	LOUISIANA
STREET ADDR. 1	814 W. MCNEESE ST, SUITE #100
CITY	LAKE CHARLES
ZIP	70605-5426
OFFICIAL VA NAME	LAKE CHARLES VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 16 PARENT FACILITY PARENT OF ASSOCIATION: ALEXANDRIA VA MEDICAL CENTER
BILLING FACILITY NAME	LAKE CHARLES VA CLINIC
EFFECTIVE DATE/TIME	2015-11-23 00:00:00 STATUS: ACTIVE NPI: 1811355779
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
STATION NUMBER	502GE
IDENTIFIER	CODING SYSTEM: CLIA ID: 19D2142425