25D2150429 CLIA NUMBER - SAFE HARBOR CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 25D2150429
  • Facility Name: SAFE HARBOR CLINIC, LLC
  • Facility Address: 4013 BEATLINE RD, STE A
    LONG BEACH, MS
    ZIP 39560
  • Facility Phone: 228 424-4425
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DUSTIN MARMALICH
  • NPI Number: 1699242891
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 25D2150429
LAB Type Physician Office
Facility Name SAFE HARBOR CLINIC, LLC
Street 4013 BEATLINE RD, STE A
City LONG BEACH
State MS
ZIP 39560
Phone 228 424-4425
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2024
Certificate Expiration Date 6/24/2026
Facility Type Physician Office
Lab Director DR. DUSTIN MARMALICH

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