25D0680635 CLIA NUMBER - DIVERSICARE OF AMORY, LLC

Laboratory Demographics

  • CLIA Code: 25D0680635
  • Facility Name: DIVERSICARE OF AMORY, LLC
  • Facility Address: 1215 EARL FRYE DRIVE
    AMORY, MS
    ZIP 38821
  • Facility Phone: 662 256-9344
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DONNA BALLARD
  • NPI Number: 1750836748
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D0680635
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name DIVERSICARE OF AMORY, LLC
Street 1215 EARL FRYE DRIVE
City AMORY
State MS
ZIP 38821
Phone 662 256-9344
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 DONNA BALLARD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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