CRESCENT CITY SURGICAL CENTRE DIAGNOSTICS, LLC
NPI 1790679512
Clinical Medical Laboratory in Florence, AL

Active since June 05, 2025CLIA 19D2016117 · Accreditation
2805 W MALL DR, FLORENCE, AL 35630(504) 766-9882(504) 504-5211 Get Directions Write a Review

NPPES record last updated: June 5, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Crescent City Surgical Centre Diagnostics, Llc NPPES

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

CRESCENT CITY SURGICAL CENTRE DIAGNOSTICS, LLC (NPI 1790679512) is a healthcare organization registered as a clinical medical laboratory in Florence, Alabama and active in the NPI registry since June 2025. The organization holds an CLIA Accreditation certificate valid through January 11, 2028 and lists William Lawrence Bouchillon, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1790679512
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameCRESCENT CITY SURGICAL CENTRE DIAGNOSTICS, LLC
Location Address2805 W MALL DRFlorence, AL 35630-1563
Mailing Address2805 W Mall DrFlorence, AL 35630-1563 · (504) 766-9882
Fax(504) 504-5211
Organization SubpartNo
Authorized OfficialWilliam Lawrence BouchillonPractice Manager · (504) 766-9882
Enumeration DateJune 5, 2025
NPPES CertifiedJune 5, 2025
NPI 1790679512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
2805 W MALL DR, Florence, AL 35630

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 Accreditation 19D2016117

Crescent City Surgical Centre Diagnostics, LLC · Metairie, LA
Active · expires Jan 11, 2028
CLIA Number19D2016117
Laboratory TypeIndependent
Certificate Effective DateJanuary 12, 2026
Certificate Expiration DateJanuary 11, 2028
Laboratory DirectorRonnie Self II
Laboratory Phone(504) 766-9882
Laboratory LocationCrescent City Surgical Centre Diagnostics, LLC3016 Galleria Drive, Metairie, LA 70001
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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 Crescent City Surgical Centre Diagnostics, LLC's NPI number?

The NPI number for Crescent City Surgical Centre Diagnostics, LLC is 1790679512. It was assigned to this organization in the NPPES registry on June 5, 2025.

Where is Crescent City Surgical Centre Diagnostics, LLC located?

Crescent City Surgical Centre Diagnostics, LLC is located at 2805 W Mall Dr, Florence, AL 35630. The listed phone number is (504) 766-9882.

What is Crescent City Surgical Centre Diagnostics, LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Crescent City Surgical Centre Diagnostics, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 19D2016117) is associated with this NPI, valid through January 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Crescent City Surgical Centre Diagnostics, LLC was last updated on June 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.