19D2311853 CLIA NUMBER - THIBODAUX REGIONAL FAMILY MEDICINE CLINIC -THIBODAUX

Laboratory Demographics

  • CLIA Code: 19D2311853
  • Facility Name: THIBODAUX REGIONAL FAMILY MEDICINE CLINIC -THIBODAUX
  • Facility Address: 604 NORTH ACADIA, SUITE 406A
    THIBODAUX, LA
    ZIP 70301
  • Facility Phone: 985 493-3034
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW TAYLOR
  • NPI Number: 1396570511
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2311853
LAB Type Physician Office
Facility Name THIBODAUX REGIONAL FAMILY MEDICINE CLINIC -THIBODAUX
Street 604 NORTH ACADIA, SUITE 406A
City THIBODAUX
State LA
ZIP 70301
Phone 985 493-3034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Physician Office
Lab Director MATTHEW TAYLOR

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