19D2035320 CLIA NUMBER - DWAYNE J BERGEAUX MD

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Laboratory Demographics

CLIA Number: 19D2035320

Facility Name: DWAYNE J BERGEAUX MD

Facility Address:
1322 ELTON ROAD, SUITE E
JENNINGS, LA
ZIP 70546
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Facility Phone Number: 337 788-2864

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1477738268

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	19D2035320
LAB Type	Physician Office
Facility Name	DWAYNE J BERGEAUX MD
Street	1322 ELTON ROAD, SUITE E
City	JENNINGS
State	LA
ZIP	70546
Phone	337 788-2864
CertificateType	3
CertificateEffectiveDate	1/17/2024
CertificateExpirationDate	1/16/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024