19D0457919 CLIA NUMBER - JEFFERSON PEDIATRIC CLINIC

Laboratory Demographics

  • CLIA Code: 19D0457919
  • Facility Name: JEFFERSON PEDIATRIC CLINIC
  • Facility Address: 1111 MEDICAL CENTER BLVD SUITE N813
    MARRERO, LA
    ZIP 70072
  • Facility Phone: 504 349-6813
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: CARLOS A. TRUJILLO
  • NPI Number: 1972642197
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 19D0457919
LAB Type Physician Office
Facility Name JEFFERSON PEDIATRIC CLINIC
Street 1111 MEDICAL CENTER BLVD SUITE N813
City MARRERO
State LA
ZIP 70072
Phone 504 349-6813
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Physician Office
Lab Director CARLOS A. TRUJILLO

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