25D0707826 CLIA NUMBER - GLEN OAKS NURSING CENTER

Laboratory Demographics

  • CLIA Code: 25D0707826
  • Facility Name: GLEN OAKS NURSING CENTER
  • Facility Address: 55 SUSANNE STREET
    LUCEDALE, MS
    ZIP 39452
  • Facility Phone: 601 947-2783
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TERESA CRABTREE
  • NPI Number: 1124019096
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D0707826
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GLEN OAKS NURSING CENTER
Street 55 SUSANNE STREET
City LUCEDALE
State MS
ZIP 39452
Phone 601 947-2783
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 TERESA CRABTREE

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