19D1054200 CLIA NUMBER - ENT OF ACADIANA

Laboratory Demographics

  • CLIA Code: 19D1054200
  • Facility Name: ENT OF ACADIANA
  • Facility Address: 426 CHARLES STREET
    NEW IBERIA, LA
    ZIP 70560
  • Facility Phone: 337 365-4156
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TYNES E. MIXON
  • NPI Number: 1720005754
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 19D1054200
LAB Type Physician Office
Facility Name ENT OF ACADIANA
Street 426 CHARLES STREET
City NEW IBERIA
State LA
ZIP 70560
Phone 337 365-4156
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2024
Certificate Expiration Date 5/14/2026
Facility Type Physician Office
Lab Director TYNES E. MIXON

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