25D2289479 CLIA NUMBER - COVINGTON PLACE - THERAPY & COUNSELING

Laboratory Demographics

CLIA Number: 25D2289479

Facility Name: COVINGTON PLACE - THERAPY & COUNSELING

Facility Address:
1207 S FIR AVE
COLLINS, MS
ZIP 39428
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Facility Phone Number: 601 698-0263

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1831895911

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D2289479
LAB Type	Physician Office
Facility Name	COVINGTON PLACE - THERAPY & COUNSELING
Street	1207 S FIR AVE
City	COLLINS
State	MS
ZIP	39428
Phone	601 698-0263
CertificateType	4
CertificateEffectiveDate	9/12/2023
CertificateExpirationDate	9/11/2025
FacilityType	Waiver

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