25D2035668 CLIA NUMBER - SOLACE HEALTH PLLC

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Laboratory Demographics

CLIA Number: 25D2035668

Facility Name: SOLACE HEALTH PLLC

Facility Address:
4900 OLD HIGHWAY 11, STE 2
HATTIESBURG, MS
ZIP 39402
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Facility Phone Number: 601 336-7700

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1447504501

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D2035668
LAB Type	Physician Office
Facility Name	SOLACE HEALTH PLLC
Street	4900 OLD HIGHWAY 11, STE 2
City	HATTIESBURG
State	MS
ZIP	39402
Phone	601 336-7700
CertificateType	4
CertificateEffectiveDate	1/23/2024
CertificateExpirationDate	1/22/2026
FacilityType	Waiver

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