25D0891924 CLIA NUMBER - MEMORIAL WOODLAND VILLAGE NURSING CENTER

Laboratory Demographics

  • CLIA Code: 25D0891924
  • Facility Name: MEMORIAL WOODLAND VILLAGE NURSING CENTER
  • Facility Address: 5427 GEX ROAD
    DIAMONDHEAD, MS
    ZIP 39525
  • Facility Phone: 228 255-4832
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ASHLEY ROSS
  • NPI Number: 1619066248
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D0891924
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MEMORIAL WOODLAND VILLAGE NURSING CENTER
Street 5427 GEX ROAD
City DIAMONDHEAD
State MS
ZIP 39525
Phone 228 255-4832
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ASHLEY ROSS

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This page was last updated on: 3/20/2025