25D1027547 CLIA NUMBER - DIGESTIVE DISEASES CENTER OF HATTIESBURG LLC

Laboratory Demographics

CLIA Number: 25D1027547

Facility Name: DIGESTIVE DISEASES CENTER OF HATTIESBURG LLC

Facility Address:
100 METHODIST BLVD
HATTIESBURG, MS
ZIP 39402
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Facility Phone Number: 601 268-5185

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1598879009

Taxonomy: 261QE0800X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D1027547
LAB Type	Ambulatory Surgery Center
Facility Name	DIGESTIVE DISEASES CENTER OF HATTIESBURG LLC
Street	100 METHODIST BLVD
City	HATTIESBURG
State	MS
ZIP	39402
Phone	601 268-5185
CertificateType	4
CertificateEffectiveDate	7/2/2022
CertificateExpirationDate	7/1/2024
FacilityType	Waiver

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