25D0969133 CLIA NUMBER - WINDHAM HOUSE OF HATTIESBURG LLC,THE

Laboratory Demographics

  • CLIA Code: 25D0969133
  • Facility Name: WINDHAM HOUSE OF HATTIESBURG LLC,THE
  • Facility Address: 37 HILLCREST DRIVE
    HATTIESBURG, MS
    ZIP 39402
  • Facility Phone: 601 264-0058
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MISTY ARDOIN
  • NPI Number: 1578511366
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D0969133
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WINDHAM HOUSE OF HATTIESBURG LLC,THE
Street 37 HILLCREST DRIVE
City HATTIESBURG
State MS
ZIP 39402
Phone 601 264-0058
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2024
Certificate Expiration Date 1/4/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MISTY ARDOIN

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