19D0941462 CLIA NUMBER - REL L GRAY MD PMC

Laboratory Demographics

  • CLIA Code: 19D0941462
  • Facility Name: REL L GRAY MD PMC
  • Facility Address: 206 EAST REYNOLDS DRIVE, SUITE C2
    RUSTON, LA
    ZIP 71270
  • Facility Phone: 318 251-1000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REL L. GRAY
  • NPI Number: 1639188527
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D0941462
LAB Type Physician Office
Facility Name REL L GRAY MD PMC
Street 206 EAST REYNOLDS DRIVE, SUITE C2
City RUSTON
State LA
ZIP 71270
Phone 318 251-1000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2024
Certificate Expiration Date 2/24/2026
Facility Type Physician Office
Lab Director REL L. GRAY

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