25D0922483 CLIA NUMBER - OCHSNER HEALTH CENTER - PHILADELPHIA

Laboratory Demographics

CLIA Number: 25D0922483

Facility Name: OCHSNER HEALTH CENTER - PHILADELPHIA

Facility Address:
1106 CENTRAL DR STE 1
PHILADELPHIA, MS
ZIP 39350
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Facility Phone Number: 601 656-6921

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1275873572

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D0922483
LAB Type	Rural Health Clinic
Facility Name	OCHSNER HEALTH CENTER - PHILADELPHIA
Street	1106 CENTRAL DR STE 1
City	PHILADELPHIA
State	MS
ZIP	39350
Phone	601 656-6921
CertificateType	4
CertificateEffectiveDate	7/26/2023
CertificateExpirationDate	7/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024