25D2032707 CLIA NUMBER - COASTAL EYE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 25D2032707
  • Facility Name: COASTAL EYE SURGERY CENTER
  • Facility Address: 14225 DEDEAUX ROAD
    GULFPORT, MS
    ZIP 39503
  • Facility Phone: 228 831-0778
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: MELISSA THOMAS
  • NPI Number: 1669757761
  • Taxonomy: 261QS0132X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2032707
LAB Type Ancillary Testing Site in Health Care Center
Facility Name COASTAL EYE SURGERY CENTER
Street 14225 DEDEAUX ROAD
City GULFPORT
State MS
ZIP 39503
Phone 228 831-0778
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Ancillary Testing Site in Health Care Center
Lab Director MELISSA THOMAS

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