25D2194369 CLIA NUMBER - MONTGOMERY GARDENS SENIOR LIVING BY AMERICARE

Laboratory Demographics

  • CLIA Code: 25D2194369
  • Facility Name: MONTGOMERY GARDENS SENIOR LIVING BY AMERICARE
  • Facility Address: 4348 OLD HWY 12 W
    STARKVILLE, MS
    ZIP 39759
  • Facility Phone: 662 323-4663
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TMARA S. BIGGER
  • NPI Number: 1972768414
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D2194369
LAB Type Assisted Living Facility
Facility Name MONTGOMERY GARDENS SENIOR LIVING BY AMERICARE
Street 4348 OLD HWY 12 W
City STARKVILLE
State MS
ZIP 39759
Phone 662 323-4663
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 TMARA S. BIGGER

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