19D2062800 CLIA NUMBER - ERIC FONTENOT, MD

Laboratory Demographics

  • CLIA Code: 19D2062800
  • Facility Name: ERIC FONTENOT, MD
  • Facility Address: 1219 COOLIDGE BLVD
    LAFAYETTE, LA
    ZIP 70503
  • Facility Phone: 337 233-4980
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERIC FONTENOT
  • NPI Number: 1437228657
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2062800
LAB Type Physician Office
Facility Name ERIC FONTENOT, MD
Street 1219 COOLIDGE BLVD
City LAFAYETTE
State LA
ZIP 70503
Phone 337 233-4980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Physician Office
Lab Director ERIC FONTENOT

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