25D0029637 CLIA NUMBER - GRENADA LIVING CENTER, LLC

Laboratory Demographics

  • CLIA Code: 25D0029637
  • Facility Name: GRENADA LIVING CENTER, LLC
  • Facility Address: 1950 GRANDVIEW
    GRENADA, MS
    ZIP 38901
  • Facility Phone: 601 226-9554
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TRICIA DORRIS
  • NPI Number: 1477501922
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D0029637
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GRENADA LIVING CENTER, LLC
Street 1950 GRANDVIEW
City GRENADA
State MS
ZIP 38901
Phone 601 226-9554
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 TRICIA DORRIS

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