25D2215262 CLIA NUMBER - NEXT LEVEL HEALTH & WELLNESS

Laboratory Demographics

CLIA Number: 25D2215262

Facility Name: NEXT LEVEL HEALTH & WELLNESS

Facility Address:
112 W WASHINGTON ST
HOLLANDALE, MS
ZIP 38748
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Facility Phone Number: 662 822-1861

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1518556968

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	25D2215262
LAB Type	Practitioner Other
Facility Name	NEXT LEVEL HEALTH & WELLNESS
Street	112 W WASHINGTON ST
City	HOLLANDALE
State	MS
ZIP	38748
Phone	662 822-1861
CertificateType	4
CertificateEffectiveDate	3/2/2023
CertificateExpirationDate	3/1/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024