25D0318913 CLIA NUMBER - FORREST GENERAL HOME CARE/HOSPICE

Laboratory Demographics

  • CLIA Code: 25D0318913
  • Facility Name: FORREST GENERAL HOME CARE/HOSPICE
  • Facility Address: 4200 MAMIE ST STE 120
    HATTIESBURG, MS
    ZIP 39402
  • Facility Phone: 601 288-4344
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: LESLIE MASTERS
  • NPI Number: 1336256700
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 25D0318913
LAB Type Home Health Agency
Facility Name FORREST GENERAL HOME CARE/HOSPICE
Street 4200 MAMIE ST STE 120
City HATTIESBURG
State MS
ZIP 39402
Phone 601 288-4344
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 Home Health Agency
Lab Director LESLIE MASTERS

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