19D2104513 CLIA NUMBER - PEDIATRIC GROUP OF ACADIANA & FAMILY CLINIC

Laboratory Demographics

CLIA Number: 19D2104513

Facility Name: PEDIATRIC GROUP OF ACADIANA & FAMILY CLINIC

Facility Address:
550 VETERANS MEMORIAL DRIVE
ERATH, LA
ZIP 70533
Get Directions

Facility Phone Number: 337 918-6341

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1073973533

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2104513
LAB Type	Rural Health Clinic
Facility Name	PEDIATRIC GROUP OF ACADIANA & FAMILY CLINIC
Street	550 VETERANS MEMORIAL DRIVE
City	ERATH
State	LA
ZIP	70533
Phone	337 918-6341
CertificateType	4
CertificateEffectiveDate	11/5/2023
CertificateExpirationDate	11/4/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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