19D2267877 CLIA NUMBER - PREMIER PEDIATRICS OF AVOYELLES

Laboratory Demographics

  • CLIA Code: 19D2267877
  • Facility Name: PREMIER PEDIATRICS OF AVOYELLES
  • Facility Address: 110 LA RUE MEDECINE
    MARKSVILLE, LA
    ZIP 71351
  • Facility Phone: 318 409-5008
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: BEAU P. BROUILLETTE
  • NPI Number: 1184619058
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2267877
LAB Type Rural Health Clinic
Facility Name PREMIER PEDIATRICS OF AVOYELLES
Street 110 LA RUE MEDECINE
City MARKSVILLE
State LA
ZIP 71351
Phone 318 409-5008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Rural Health Clinic
Lab Director BEAU P. BROUILLETTE

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