19D2163242 CLIA NUMBER - REACH FOR RECOVERY, LLC

Laboratory Demographics

  • CLIA Code: 19D2163242
  • Facility Name: REACH FOR RECOVERY, LLC
  • Facility Address: 1701 OLD MINDEN ROAD, STE 17F
    BOSSIER CITY, LA
    ZIP 71112
  • Facility Phone: 318 317-1238
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIA D. THOMAS
  • NPI Number: 1124764964
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 19D2163242
LAB Type Physician Office
Facility Name REACH FOR RECOVERY, LLC
Street 1701 OLD MINDEN ROAD, STE 17F
City BOSSIER CITY
State LA
ZIP 71112
Phone 318 317-1238
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Physician Office
Lab Director TIA D. THOMAS

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