19D0457773 CLIA NUMBER - JOSEPH M GAUTREAUX III MD

Laboratory Demographics

  • CLIA Code: 19D0457773
  • Facility Name: JOSEPH M GAUTREAUX III MD
  • Facility Address: 1302 WILLIAMS BLVD
    KENNER, LA
    ZIP 70062
  • Facility Phone: 504 464-8683
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JOSEPH M. GAUTREAUX III
  • NPI Number: 1326179508
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 19D0457773
LAB Type Practitioner Other
Facility Name JOSEPH M GAUTREAUX III MD
Street 1302 WILLIAMS BLVD
City KENNER
State LA
ZIP 70062
Phone 504 464-8683
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type Practitioner Other
Lab Director JOSEPH M. GAUTREAUX III

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