25D2069441 CLIA NUMBER - BENNDALE ELEMENTARY

Laboratory Demographics

CLIA Code: 25D2069441
Facility Name: BENNDALE ELEMENTARY
Facility Address: 5204 HWY 26 WEST
LUCEDALE, MS
ZIP 39452
Facility Phone: 601 206-0098
Facility Type: School/Student Health Service
Facility Type: Waiver
Lab Director: COURTNEY BURNS
NPI Number: 1376973057
Taxonomy: 390200000X - Student in an Organized Health Care Education/Training Program

Map and Directions

Get Directions

CLIA Record

Field Name	Field Value
CLIA Number	25D2069441
LAB Type	School/Student Health Service
Facility Name	BENNDALE ELEMENTARY
Street	5204 HWY 26 WEST
City	LUCEDALE
State	MS
ZIP	39452
Phone	601 206-0098
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	8/5/2025
Certificate Expiration Date	8/4/2027
Facility Type	School/Student Health Service
Lab Director	COURTNEY BURNS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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