19D0931540 CLIA NUMBER - THIBODAUX REGIONAL FAMILY MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 19D0931540
  • Facility Name: THIBODAUX REGIONAL FAMILY MEDICINE CLINIC
  • Facility Address: 3928 HIGHWAY 70 S
    PIERRE PART, LA
    ZIP 70339
  • Facility Phone: 985 252-1111
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KEITH LANDRY
  • NPI Number: 1396162269
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D0931540
LAB Type Physician Office
Facility Name THIBODAUX REGIONAL FAMILY MEDICINE CLINIC
Street 3928 HIGHWAY 70 S
City PIERRE PART
State LA
ZIP 70339
Phone 985 252-1111
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/30/2025
Certificate Expiration Date 7/29/2027
Facility Type Physician Office
Lab Director KEITH LANDRY

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