25D0317160 CLIA NUMBER - PONTOTOC HEALTH AND REHAB CENTER

Laboratory Demographics

  • CLIA Code: 25D0317160
  • Facility Name: PONTOTOC HEALTH AND REHAB CENTER
  • Facility Address: 278 W EIGHTH ST
    PONTOTOC, MS
    ZIP 38863
  • Facility Phone: 662 489-6411
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SAMANTHA BROWN
  • NPI Number: 1548373665
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D0317160
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PONTOTOC HEALTH AND REHAB CENTER
Street 278 W EIGHTH ST
City PONTOTOC
State MS
ZIP 38863
Phone 662 489-6411
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 SAMANTHA BROWN

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