19D2166572 CLIA NUMBER - BRYANT MEDICAL GROUP

Laboratory Demographics

CLIA Number: 19D2166572

Facility Name: BRYANT MEDICAL GROUP

Facility Address:
208 RUE LOUIS XIV
LAFAYETTE, LA
ZIP 70508
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Facility Phone Number: 337 367-2567

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184112450

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	19D2166572
LAB Type	Physician Office
Facility Name	BRYANT MEDICAL GROUP
Street	208 RUE LOUIS XIV
City	LAFAYETTE
State	LA
ZIP	70508
Phone	337 367-2567
CertificateType	4
CertificateEffectiveDate	5/21/2023
CertificateExpirationDate	5/20/2025
FacilityType	Waiver

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