25D2194359 CLIA NUMBER - OLIVE GROVE TERRACE ASSISTED LIVING BY AMERICARE

Laboratory Demographics

  • CLIA Code: 25D2194359
  • Facility Name: OLIVE GROVE TERRACE ASSISTED LIVING BY AMERICARE
  • Facility Address: 9684 GOODMAN RD
    OLIVE BRANCH, MS
    ZIP 38654
  • Facility Phone: 662 895-7609
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: VICTORIA L. NORTON
  • NPI Number: 1225127426
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D2194359
LAB Type Assisted Living Facility
Facility Name OLIVE GROVE TERRACE ASSISTED LIVING BY AMERICARE
Street 9684 GOODMAN RD
City OLIVE BRANCH
State MS
ZIP 38654
Phone 662 895-7609
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Assisted Living Facility
Lab Director VICTORIA L. NORTON

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