25D2307871 CLIA NUMBER - BRADFORD RIVER BEND

Laboratory Demographics

  • CLIA Code: 25D2307871
  • Facility Name: BRADFORD RIVER BEND
  • Facility Address: 330 HWY 90
    GAUTIER, MS
    ZIP 39553
  • Facility Phone: 228 299-0599
  • Facility Type: Other - PARTIAL HOSPITALIZATION
  • Facility Type: Waiver
  • Lab Director: DONALD FAUCETT
  • NPI Number: 1194569855
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2307871
LAB Type Other - PARTIAL HOSPITALIZATION
Facility Name BRADFORD RIVER BEND
Street 330 HWY 90
City GAUTIER
State MS
ZIP 39553
Phone 228 299-0599
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2024
Certificate Expiration Date 7/15/2026
Facility Type Other - PARTIAL HOSPITALIZATION
Lab Director DONALD FAUCETT

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