19D2253149 CLIA NUMBER - PATIENT CENTERED DIAGNOSTICS LLC

Laboratory Demographics

  • CLIA Code: 19D2253149
  • Facility Name: PATIENT CENTERED DIAGNOSTICS LLC
  • Facility Address: 1425 LYNNE STREET
    THIBODAUX, LA
    ZIP 70301
  • Facility Phone: 985 492-1005
  • Facility Type: Other - DAIG TESTING CENTER
  • Facility Type: Waiver
  • Lab Director: JONTELL MARIE JOHNSON
  • NPI Number: 1235883943
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2253149
LAB Type Other - DAIG TESTING CENTER
Facility Name PATIENT CENTERED DIAGNOSTICS LLC
Street 1425 LYNNE STREET
City THIBODAUX
State LA
ZIP 70301
Phone 985 492-1005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Other - DAIG TESTING CENTER
Lab Director JONTELL MARIE JOHNSON

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