19D0460101 CLIA NUMBER - DERRIS W RAY MD

Laboratory Demographics

  • CLIA Code: 19D0460101
  • Facility Name: DERRIS W RAY MD
  • Facility Address: 309 WALNUT STREET, SUITE D
    AMITE, LA
    ZIP 70422
  • Facility Phone: 985 748-5158
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DERRIS W. RAY
  • NPI Number: 1780679746
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 19D0460101
LAB Type Physician Office
Facility Name DERRIS W RAY MD
Street 309 WALNUT STREET, SUITE D
City AMITE
State LA
ZIP 70422
Phone 985 748-5158
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DERRIS W. RAY

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