19D2188037 CLIA NUMBER - RAY'S PHARMACY, LLC RAY'S PHARMACY ON VERSAILLES

Laboratory Demographics

  • CLIA Code: 19D2188037
  • Facility Name: RAY'S PHARMACY, LLC RAY'S PHARMACY ON VERSAILLES
  • Facility Address: 4629 SHREVEPORT HWY
    TIOGA, LA
    ZIP 71477
  • Facility Phone: 318 640-5882
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLEY BRADFORD
  • NPI Number: 1033508544
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2188037
LAB Type Pharmacy
Facility Name RAY'S PHARMACY, LLC RAY'S PHARMACY ON VERSAILLES
Street 4629 SHREVEPORT HWY
City TIOGA
State LA
ZIP 71477
Phone 318 640-5882
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2024
Certificate Expiration Date 7/12/2026
Facility Type Pharmacy
Lab Director KELLEY BRADFORD

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