19D2261898 CLIA NUMBER - BEAUREGARD CARDIOLOGY CENTER

Laboratory Demographics

  • CLIA Code: 19D2261898
  • Facility Name: BEAUREGARD CARDIOLOGY CENTER
  • Facility Address: 200 WEST 5TH STREET
    DERIDDER, LA
    ZIP 70634
  • Facility Phone: (337) 221-1417
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDWIN R. BONILLA
  • NPI Number: 1891124384
  • Taxonomy: 208800000X - Urology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 19D2261898
LAB Type Physician Office
Facility Name BEAUREGARD CARDIOLOGY CENTER
Street 200 WEST 5TH STREET
City DERIDDER
State LA
ZIP 70634
Phone 3372211417
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2026
Certificate Expiration Date 6/6/2028
Facility Type Physician Office
Lab Director EDWIN R. BONILLA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 5/18/2026