25D2026603 CLIA NUMBER - BIENVILLE ORTHOPAEDIC SPECIALISTS

Laboratory Demographics

  • CLIA Code: 25D2026603
  • Facility Name: BIENVILLE ORTHOPAEDIC SPECIALISTS
  • Facility Address: 6300 EAST LAKE BLVD, STE 201
    VANCLEAVE, MS
    ZIP 39565
  • Facility Phone: 228 230-2663
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DONNIS HARRISON
  • NPI Number: 1689605834
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 25D2026603
LAB Type Physician Office
Facility Name BIENVILLE ORTHOPAEDIC SPECIALISTS
Street 6300 EAST LAKE BLVD, STE 201
City VANCLEAVE
State MS
ZIP 39565
Phone 228 230-2663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2025
Certificate Expiration Date 7/5/2027
Facility Type Physician Office
Lab Director DONNIS HARRISON

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