19D2029424 CLIA NUMBER - THIBODAUX REGIONAL INTERNAL MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 19D2029424
  • Facility Name: THIBODAUX REGIONAL INTERNAL MEDICINE CLINIC
  • Facility Address: 400 NORTH ACADIA ROAD
    THIBODAUX, LA
    ZIP 70301
  • Facility Phone: 985 493-4004
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. DEVIN M. BOURGEOIS
  • NPI Number: 1396175857
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2029424
LAB Type Physician Office
Facility Name THIBODAUX REGIONAL INTERNAL MEDICINE CLINIC
Street 400 NORTH ACADIA ROAD
City THIBODAUX
State LA
ZIP 70301
Phone 985 493-4004
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Physician Office
Lab Director DR. DEVIN M. BOURGEOIS

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