25D2194187 CLIA NUMBER - BELLEVUE ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 25D2194187
  • Facility Name: BELLEVUE ASSISTED LIVING
  • Facility Address: 34 GRAHAM RD
    HATTIESBURG, MS
    ZIP 39402
  • Facility Phone: 601 818-2016
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DAN JOHNSTON
  • NPI Number: 1629300512
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2194187
LAB Type Assisted Living Facility
Facility Name BELLEVUE ASSISTED LIVING
Street 34 GRAHAM RD
City HATTIESBURG
State MS
ZIP 39402
Phone 601 818-2016
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Assisted Living Facility
Lab Director DAN JOHNSTON

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