19D2149234 CLIA NUMBER - PREMIER PEDIATRICS OF LOUISIANA

Laboratory Demographics

  • CLIA Code: 19D2149234
  • Facility Name: PREMIER PEDIATRICS OF LOUISIANA
  • Facility Address: 325 W 8TH ST
    DERIDDER, LA
    ZIP 70634
  • Facility Phone: 337 221-3075
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JENNIFER MIDGETT
  • NPI Number: 1740769082
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2149234
LAB Type Practitioner Other
Facility Name PREMIER PEDIATRICS OF LOUISIANA
Street 325 W 8TH ST
City DERIDDER
State LA
ZIP 70634
Phone 337 221-3075
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2024
Certificate Expiration Date 5/28/2026
Facility Type Practitioner Other
Lab Director JENNIFER MIDGETT

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