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CHURCH POINT MEDICAL CLINIC LLC
NPI 1114144888
Clinic/Center - Medical Specialty in Church Point, LA

Active since April 20, 2007CLIA 19D1003969 · Waiver
731 S MAIN ST, SUITE A, CHURCH POINT, LA 70525(337) 684-0911(337) 684-0912 Get Directions Write a Review

NPPES record last updated: June 21, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Church Point Medical Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHURCH POINT MEDICAL CLINIC LLC (NPI 1114144888) is a healthcare organization registered as a medical specialty in Church Point, Louisiana and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through September 15, 2026 and lists Marcelo Polanco, Owner, as its authorized official.

NPPES Registry Identity

NPI1114144888
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameCHURCH POINT MEDICAL CLINIC LLC
Location Address731 S MAIN ST, SUITE AChurch Point, LA 70525-4109
Mailing Address731 S Main St, Suite AChurch Point, LA 70525-4109 · (337) 684-0911 · Fax (337) 684-0912
Phone(337) 684-0911
Fax(337) 684-0912
Organization SubpartNo
Authorized OfficialMarcelo PolancoOwner · (337) 684-0911
Enumeration DateApril 20, 2007
Last NPPES UpdateJune 21, 2011
✔ NPI 1114144888 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in LA · LA023828
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
731 S MAIN ST, Church Point, LA 70525
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Other Identifiers 3

Medicare UPINH12838LA
Medicare PIN5CK69LA
Medicaid1485438LA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 19D1003969

Church Point Medical Clinic · Church Point, LA
Active · expires Sep 15, 2026
CLIA Number19D1003969
Laboratory TypePhysician Office
Certificate Effective DateSeptember 16, 2024
Certificate Expiration DateSeptember 15, 2026
Laboratory DirectorJimmy Legros III
Laboratory Phone(337) 684-0911
Laboratory LocationChurch Point Medical Clinic731 South Main Street, Suite A, Church Point, LA 70525
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHURCH POINT COMMUNITY PHARMACY
Pharmacy (Long Term Care Pharmacy)
731 S MAIN ST
CHURCH POINT, LA 70525
Acadia Parish (337) 684-1911
J & A LEGROS ENTERPRISES LLC
Nurse Practitioner (Family)
731 S MAIN ST, SUITE A
CHURCH POINT, LA 70525
Acadia Parish (337) 684-0911
CHAD BODIN R.P.H.
Pharmacist
731 S MAIN ST
CHURCH POINT, LA 70525
Acadia Parish (337) 684-1911
CHURCH POINT COMMUNITY PHARMACY
Pharmacy (Community/Retail Pharmacy)
731 S MAIN ST, SUITE B
CHRUCH POINT, LA 70525
Acadia Parish (337) 684-1911

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Church Point Medical Clinic LLC's NPI number?

The NPI number for Church Point Medical Clinic LLC is 1114144888. It was assigned to this organization in the NPPES registry on April 20, 2007.

Where is Church Point Medical Clinic LLC located?

Church Point Medical Clinic LLC is located at 731 S Main St Suite A, Church Point, LA 70525. The listed phone number is (337) 684-0911.

What is Church Point Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Does Church Point Medical Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 19D1003969) is associated with this NPI, valid through September 15, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Church Point Medical Clinic LLC was last updated on June 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.