25D0316404 CLIA NUMBER - CLARKSDALE NURSING CENTER

Laboratory Demographics

  • CLIA Code: 25D0316404
  • Facility Name: CLARKSDALE NURSING CENTER
  • Facility Address: 1120 RITCHIE AVE
    CLARKSDALE, MS
    ZIP 38614
  • Facility Phone: 662 627-2591
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JODI HILLMAN
  • NPI Number: 1740238930
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D0316404
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CLARKSDALE NURSING CENTER
Street 1120 RITCHIE AVE
City CLARKSDALE
State MS
ZIP 38614
Phone 662 627-2591
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JODI HILLMAN

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