19D1068041 CLIA NUMBER - SOUTHSIDE PEDIATRICS, APMC

Laboratory Demographics

  • CLIA Code: 19D1068041
  • Facility Name: SOUTHSIDE PEDIATRICS, APMC
  • Facility Address: 811 ALBERTSONS PKWY SUITE A
    BROUSSARD, LA
    ZIP 70518
  • Facility Phone: 337 839-2265
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARLOS BRUNO
  • NPI Number: 1609334390
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 19D1068041
LAB Type Physician Office
Facility Name SOUTHSIDE PEDIATRICS, APMC
Street 811 ALBERTSONS PKWY SUITE A
City BROUSSARD
State LA
ZIP 70518
Phone 337 839-2265
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Physician Office
Lab Director CARLOS BRUNO

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