CLIA lab
CLIA 25D0669929: Diversicare of Southaven, LLC
Southaven, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D0669929 belongs to Diversicare of Southaven, LLC in Southaven, MS.
Certificate of Waiver, effective September 1, 2026, expires August 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 24, 1992
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 25D0669929
- Lab name
- Diversicare of Southaven, LLC
- Address
- 1730 Dorchester Dr, Southaven, MS 38671
- Phone
- (662) 393-0050
- Fax
- (662) 393-5179
Annual test volume the lab reported
- Waived tests
- 3,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Diversicare of SouthavenCMS Care Compare ratings for the facility at the same street address
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- Axon Surgical Center, LLCCertificate of Waiver, Ambulatory surgery center25D2344998
- BMG - Desoto Primary Care AssociatesCertificate of Waiver, Physician office25D2046244
- BMG Idtf Mid South Imaging CenterCertificate of Waiver, Ancillary test site25D2269466
- BMG Southaven Family PracticeCertificate of Waiver, Physician office25D2262142
- Balanced Minds and Wellness PLLCCertificate of Waiver, Physician office25D2346667
- Baptist Memorial HospitalCertificate of Accreditation, Hospital25D0316619
- Baptist Memorial Hospital Union Cty - BccdCertificate of Accreditation, Physician office25D0969587
- Baptist Memorial Medical Group, Inc- DWCCertificate of Waiver, Physician office25D2097401
Related
Questions
What is the CLIA number for Diversicare of Southaven, LLC in Southaven?
25D0669929, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Diversicare of Southaven, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D0669929 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.