25D0913953 CLIA NUMBER - BRANDON RENAL CENTER

Laboratory Demographics

  • CLIA Code: 25D0913953
  • Facility Name: BRANDON RENAL CENTER
  • Facility Address: 101 CHRISTIAN DRIVE
    BRANDON, MS
    ZIP 39042
  • Facility Phone: 601 824-9700
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: GARY DAVIS
  • NPI Number: 1790723831
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D0913953
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BRANDON RENAL CENTER
Street 101 CHRISTIAN DRIVE
City BRANDON
State MS
ZIP 39042
Phone 601 824-9700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/15/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director GARY DAVIS

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