19D0718988 CLIA NUMBER - LEGACY NURSING & REHABILITATION OF TALLULAH TALLULAH OPCO, LLC

Laboratory Demographics

  • CLIA Code: 19D0718988
  • Facility Name: LEGACY NURSING & REHABILITATION OF TALLULAH TALLULAH OPCO, LLC
  • Facility Address: 32 CROTHERS DRIVE
    TALLULAH, LA
    ZIP 71282
  • Facility Phone: 318 574-8111
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CATRINA M. GRANT
  • NPI Number: 1265086979
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 19D0718988
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LEGACY NURSING & REHABILITATION OF TALLULAH TALLULAH OPCO, LLC
Street 32 CROTHERS DRIVE
City TALLULAH
State LA
ZIP 71282
Phone 318 574-8111
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 Skilled Nursing Facility/Nursing Facility
Lab Director CATRINA M. GRANT

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