25D1000302 CLIA NUMBER - RIVER CHASE VILLAGE

Laboratory Demographics

  • CLIA Code: 25D1000302
  • Facility Name: RIVER CHASE VILLAGE
  • Facility Address: 5090 GAUTIER VANCLEAVE ROAD
    GAUTIER, MS
    ZIP 39553
  • Facility Phone: 228 522-6700
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHRIS H. CHEEK
  • NPI Number: 1962508119
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D1000302
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name RIVER CHASE VILLAGE
Street 5090 GAUTIER VANCLEAVE ROAD
City GAUTIER
State MS
ZIP 39553
Phone 228 522-6700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2024
Certificate Expiration Date 6/6/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHRIS H. CHEEK

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