25D0995919 CLIA NUMBER - WILLOW CREEK RETIREMENT CENTER

Laboratory Demographics

  • CLIA Code: 25D0995919
  • Facility Name: WILLOW CREEK RETIREMENT CENTER
  • Facility Address: 49 WILLOW CREEK LANE
    BYRAM, MS
    ZIP 39272
  • Facility Phone: 601 863-4201
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LISHA WOODARD
  • NPI Number: 1780758904
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D0995919
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WILLOW CREEK RETIREMENT CENTER
Street 49 WILLOW CREEK LANE
City BYRAM
State MS
ZIP 39272
Phone 601 863-4201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2024
Certificate Expiration Date 2/4/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LISHA WOODARD

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