19D0459638 CLIA NUMBER - THIBODAUX REGIONAL PEDIATRIC CLINIC

Laboratory Demographics

  • CLIA Code: 19D0459638
  • Facility Name: THIBODAUX REGIONAL PEDIATRIC CLINIC
  • Facility Address: 604 NORTH ACADIA RD SUITE 100
    THIBODAUX, LA
    ZIP 70301
  • Facility Phone: 985 447-9045
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHEILA PITRE
  • NPI Number: 1447854294
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 19D0459638
LAB Type Physician Office
Facility Name THIBODAUX REGIONAL PEDIATRIC CLINIC
Street 604 NORTH ACADIA RD SUITE 100
City THIBODAUX
State LA
ZIP 70301
Phone 985 447-9045
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2024
Certificate Expiration Date 5/18/2026
Facility Type Physician Office
Lab Director SHEILA PITRE

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