19D2151909 CLIA NUMBER - SOUTHERN OBGYN, LLC

Laboratory Demographics

  • CLIA Code: 19D2151909
  • Facility Name: SOUTHERN OBGYN, LLC
  • Facility Address: 155 HOSPITAL DR, SUITE 410
    LAFAYETTE, LA
    ZIP 70503
  • Facility Phone: 337 235-4460
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER B. PUGLIESE
  • NPI Number: 1174015945
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 19D2151909
LAB Type Physician Office
Facility Name SOUTHERN OBGYN, LLC
Street 155 HOSPITAL DR, SUITE 410
City LAFAYETTE
State LA
ZIP 70503
Phone 337 235-4460
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Physician Office
Lab Director JENNIFER B. PUGLIESE

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