25D2050515 CLIA NUMBER - SOUTHERNCARE INC DBA GENTIVA

Laboratory Demographics

  • CLIA Code: 25D2050515
  • Facility Name: SOUTHERNCARE INC DBA GENTIVA
  • Facility Address: 2706 W OXFORD LOOP STE 100
    OXFORD, MS
    ZIP 38655
  • Facility Phone: 662 234-0140
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SELECE Y. BEASLEY
  • NPI Number: 1326088154
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 25D2050515
LAB Type Hospice
Facility Name SOUTHERNCARE INC DBA GENTIVA
Street 2706 W OXFORD LOOP STE 100
City OXFORD
State MS
ZIP 38655
Phone 662 234-0140
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2024
Certificate Expiration Date 11/29/2026
Facility Type Hospice
Lab Director SELECE Y. BEASLEY

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