25D0708994 CLIA NUMBER - SINGING RIVER GULFPORT WALK-IN & FAMILY PRACTICE CLINIC

Laboratory Demographics

  • CLIA Code: 25D0708994
  • Facility Name: SINGING RIVER GULFPORT WALK-IN & FAMILY PRACTICE CLINIC
  • Facility Address: 350 COWAN ROAD
    GULFPORT, MS
    ZIP 39507
  • Facility Phone: 228 206-7054
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CURTIS A. BROUSSARD
  • NPI Number: 1861010159
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D0708994
LAB Type Physician Office
Facility Name SINGING RIVER GULFPORT WALK-IN & FAMILY PRACTICE CLINIC
Street 350 COWAN ROAD
City GULFPORT
State MS
ZIP 39507
Phone 228 206-7054
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2023
Certificate Expiration Date 11/4/2025
Facility Type Physician Office
Lab Director DR. CURTIS A. BROUSSARD

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This page was last updated on: 6/4/2025