25D2000670 CLIA NUMBER - SPRING VALLEY HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 25D2000670
  • Facility Name: SPRING VALLEY HOSPICE LLC
  • Facility Address: 7139 COMMERCE DRIVE BZ
    OLIVE BRANCH, MS
    ZIP 38654
  • Facility Phone: 662 890-5554
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: RONALD B. WOLLWERT
  • NPI Number: 1790159358
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 25D2000670
LAB Type Hospice
Facility Name SPRING VALLEY HOSPICE LLC
Street 7139 COMMERCE DRIVE BZ
City OLIVE BRANCH
State MS
ZIP 38654
Phone 662 890-5554
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Hospice
Lab Director RONALD B. WOLLWERT

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