25D2050516 CLIA NUMBER - SOUTHERNCARE, INC DBA GENTIVA

Laboratory Demographics

  • CLIA Code: 25D2050516
  • Facility Name: SOUTHERNCARE, INC DBA GENTIVA
  • Facility Address: 925 TOMMY MUNRO DRIVE, STE J
    BILOXI, MS
    ZIP 39532
  • Facility Phone: 228 396-4756
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SELECE BEASLEY
  • NPI Number: 1053350850
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 25D2050516
LAB Type Hospice
Facility Name SOUTHERNCARE, INC DBA GENTIVA
Street 925 TOMMY MUNRO DRIVE, STE J
City BILOXI
State MS
ZIP 39532
Phone 228 396-4756
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 BEASLEY

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