19D2002193 CLIA NUMBER - COMMUNITY BRIDGES SOUTH

Laboratory Demographics

  • CLIA Code: 19D2002193
  • Facility Name: COMMUNITY BRIDGES SOUTH
  • Facility Address: 155 WOODSHIRE LANE
    RUSTON, LA
    ZIP 71270
  • Facility Phone: 318 255-8072
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: MICHAEL L. REYNOLDS
  • NPI Number: 1467692137
  • Taxonomy: 253Z00000X - In Home Supportive Care

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CLIA Record

Field Name Field Value
CLIA Number 19D2002193
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name COMMUNITY BRIDGES SOUTH
Street 155 WOODSHIRE LANE
City RUSTON
State LA
ZIP 71270
Phone 318 255-8072
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director MICHAEL L. REYNOLDS

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