25D0890581 CLIA NUMBER - COMMUNITY PLACE

Laboratory Demographics

  • CLIA Code: 25D0890581
  • Facility Name: COMMUNITY PLACE
  • Facility Address: 116 LAKE VISTA PLACE
    BRANDON, MS
    ZIP 39047
  • Facility Phone: 601 355-0617
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BLANCHE REED
  • NPI Number: 1649363680
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D0890581
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name COMMUNITY PLACE
Street 116 LAKE VISTA PLACE
City BRANDON
State MS
ZIP 39047
Phone 601 355-0617
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2024
Certificate Expiration Date 8/21/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BLANCHE REED

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