25D0317488 CLIA NUMBER - JEFFERSON COUNTY HOSPITAL

Laboratory Demographics

  • CLIA Code: 25D0317488
  • Facility Name: JEFFERSON COUNTY HOSPITAL
  • Facility Address: 870 MAIN STREET
    FAYETTE, MS
    ZIP 39069
  • Facility Phone: 601 786-3401
  • Facility Type: Hospital
  • Facility Type: Certificate of Compliance
  • Lab Director: THOMAS A. ROSE
  • NPI Number: 1225247505
  • Taxonomy: 207QH0002X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D0317488
LAB Type Hospital
Facility Name JEFFERSON COUNTY HOSPITAL
Street 870 MAIN STREET
City FAYETTE
State MS
ZIP 39069
Phone 601 786-3401
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 2/18/2025
Certificate Expiration Date 2/17/2027
Facility Type Hospital
Lab Director THOMAS A. ROSE

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