19D2105099 CLIA NUMBER - STACEY W MAYEAUX MD

Laboratory Demographics

  • CLIA Code: 19D2105099
  • Facility Name: STACEY W MAYEAUX MD
  • Facility Address: 519 E PRUDHOMME ROAD
    OPELOUSAS, LA
    ZIP 70570
  • Facility Phone: 337 678-3755
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STACEY W. MAYEAUX
  • NPI Number: 1013986892
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2105099
LAB Type Physician Office
Facility Name STACEY W MAYEAUX MD
Street 519 E PRUDHOMME ROAD
City OPELOUSAS
State LA
ZIP 70570
Phone 337 678-3755
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Physician Office
Lab Director STACEY W. MAYEAUX

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