19D0673862 CLIA NUMBER - COLONIAL MANOR NURSING & REHABILITATION CENTER MACON RIDGE PROPERTIES LLC

Laboratory Demographics

  • CLIA Code: 19D0673862
  • Facility Name: COLONIAL MANOR NURSING & REHABILITATION CENTER MACON RIDGE PROPERTIES LLC
  • Facility Address: 307 FOSTER STREET
    RAYVILLE, LA
    ZIP 71269
  • Facility Phone: 318 728-3251
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DELBERT T. WILBANKS
  • NPI Number: 1518474238
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 19D0673862
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name COLONIAL MANOR NURSING & REHABILITATION CENTER MACON RIDGE PROPERTIES LLC
Street 307 FOSTER STREET
City RAYVILLE
State LA
ZIP 71269
Phone 318 728-3251
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 DELBERT T. WILBANKS

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This page was last updated on: 6/4/2025