19D0722396 CLIA NUMBER - BREAUX BRIDGE SCHOOL BASED HEALTH CTR

Laboratory Demographics

  • CLIA Code: 19D0722396
  • Facility Name: BREAUX BRIDGE SCHOOL BASED HEALTH CTR
  • Facility Address: 328 NORTH MAIN STREET
    BREAUX BRIDGE, LA
    ZIP 70517
  • Facility Phone: 337 909-3040
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: BENJAMIN T. DEGATUR
  • NPI Number: 1619192010
  • Taxonomy: 261QS1000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D0722396
LAB Type School/Student Health Service
Facility Name BREAUX BRIDGE SCHOOL BASED HEALTH CTR
Street 328 NORTH MAIN STREET
City BREAUX BRIDGE
State LA
ZIP 70517
Phone 337 909-3040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type School/Student Health Service
Lab Director BENJAMIN T. DEGATUR

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