25D2094916 CLIA NUMBER - D'IBERVILLE HOME PROGRAM LLC

Laboratory Demographics

  • CLIA Code: 25D2094916
  • Facility Name: D'IBERVILLE HOME PROGRAM LLC
  • Facility Address: 14215 COOK ROAD
    BILOXI, MS
    ZIP 39532
  • Facility Phone: 228 872-0516
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. JOSEPH OGORMAN
  • NPI Number: 1659767150
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2094916
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name D'IBERVILLE HOME PROGRAM LLC
Street 14215 COOK ROAD
City BILOXI
State MS
ZIP 39532
Phone 228 872-0516
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. JOSEPH OGORMAN

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