19D1005933 CLIA NUMBER - PEDIATRIC AND ADOLESCENT CLINIC OF LOUISIANA LLC

Laboratory Demographics

  • CLIA Code: 19D1005933
  • Facility Name: PEDIATRIC AND ADOLESCENT CLINIC OF LOUISIANA LLC
  • Facility Address: 1806 CARTER STREET
    VIDALIA, LA
    ZIP 71373
  • Facility Phone: (318) 336-7172
  • Facility Type: Rural Health Clinic
  • Facility Type: Certificate of Compliance
  • Lab Director: DAVID A. TIMM
  • NPI Number: 1346092038
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 19D1005933
LAB Type Rural Health Clinic
Facility Name PEDIATRIC AND ADOLESCENT CLINIC OF LOUISIANA LLC
Street 1806 CARTER STREET
City VIDALIA
State LA
ZIP 71373
Phone 3183367172
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 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Rural Health Clinic
Lab Director DAVID A. TIMM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 5/18/2026