CLIA lab
CLIA 25D0691302: Shady Lawn LLC
Vicksburg, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D0691302 belongs to Shady Lawn LLC in Vicksburg, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
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
- April 19, 1994
- 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
- 25D0691302
- Lab name
- Shady Lawn LLC
- Additional name
- DBA Shady Lawn Health and Rehabilitation
- Address
- 60 Shady Lawn Place, Vicksburg, MS 39180
- Phone
- (601) 636-1448
Annual test volume the lab reported
- Waived tests
- 250
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Shady Lawn Health and RehabilitationCMS Care Compare ratings for the facility at the same street address
Other labs in Vicksburg, MS
- Amedisys Mississippi LLC DBACertificate of Waiver, Home health agency25D0708937
- Biometric Solutions LLCCertificate of Waiver, Independent25D2306626
- Bluffs Rehabilitation and Healthcare Center, theCertificate of Waiver, Skilled nursing or nursing facility25D0708259
- Caring Hands Ppec of VicksburgCertificate of Waiver, Other25D2111535
- Center for Pregnancy ChoicesCertificate of Waiver, Community clinic25D2026952
- Complete Care Rural Health ClinicCertificate of Waiver, Physician office25D1068392
- Empower Childrens Clinic-VicksburgCertificate of Waiver, Physician office25D2299095
- Fast Pace Mississippi, PLLCCertificate of Waiver, Physician office25D2191040
- Fresenius Medical Care Vicksburg Home LLCCertificate of Waiver, End stage renal disease dialysis facility25D2226035
- Gi Associates EndoscopyCertificate of Waiver, Ambulatory surgery center25D1055997
Related
Questions
What is the CLIA number for Shady Lawn LLC in Vicksburg?
25D0691302, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Shady Lawn LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D0691302 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.